Healthcare Provider Details
I. General information
NPI: 1104390558
Provider Name (Legal Business Name): ANAILY GARCIA GARCIA BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/18/2019
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2115 10TH AVE N
LAKE WORTH BEACH FL
33461-3345
US
IV. Provider business mailing address
3301 ELIZABETH PL S
PALM SPRINGS FL
33461-2036
US
V. Phone/Fax
- Phone: 561-506-3665
- Fax:
- Phone: 786-399-8134
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 0189255 |
| License Number State | FL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 1-19-36025 |
| License Number State | FL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: