Healthcare Provider Details

I. General information

NPI: 1003268137
Provider Name (Legal Business Name): ARACELIS ZALDIVAR GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2016
Last Update Date: 04/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 E 14TH ST
HIALEAH FL
33010-3220
US

IV. Provider business mailing address

630 E 14TH ST
HIALEAH FL
33010-3220
US

V. Phone/Fax

Practice location:
  • Phone: 786-715-7120
  • Fax:
Mailing address:
  • Phone: 786-715-7120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: