Healthcare Provider Details

I. General information

NPI: 1720943921
Provider Name (Legal Business Name): ALONDRA GARCIA-HUIZACHE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4222 S FLORIDA AVE
LAKELAND FL
33813-1628
US

IV. Provider business mailing address

604 N HENDRY AVE
FORT MEADE FL
33841-2216
US

V. Phone/Fax

Practice location:
  • Phone: 863-456-7148
  • Fax:
Mailing address:
  • Phone: 863-812-1649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSI6831
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: