Healthcare Provider Details

I. General information

NPI: 1801781372
Provider Name (Legal Business Name): YANEISY GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 06/12/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 S JOHN YOUNG PKWY
KISSIMMEE FL
34741-0603
US

IV. Provider business mailing address

1142 CHELSEA DR
DAVENPORT FL
33897-6285
US

V. Phone/Fax

Practice location:
  • Phone: 407-201-6255
  • Fax: 407-201-7195
Mailing address:
  • Phone: 863-969-6240
  • 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: