Healthcare Provider Details

I. General information

NPI: 1245938943
Provider Name (Legal Business Name): LAURA CHAVES GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4236 W 16TH AVE
HIALEAH FL
33012-7624
US

IV. Provider business mailing address

11311 SW 147TH CT
MIAMI FL
33196-3344
US

V. Phone/Fax

Practice location:
  • Phone: 786-409-2646
  • Fax: 786-953-6553
Mailing address:
  • Phone: 786-672-5995
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: