Healthcare Provider Details

I. General information

NPI: 1720503162
Provider Name (Legal Business Name): ISBELL OLIVA-GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2017
Last Update Date: 08/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8785 SW 165TH AVE STE 103
MIAMI FL
33193
US

IV. Provider business mailing address

17063 SW 215TH TER
MIAMI FL
33187-4313
US

V. Phone/Fax

Practice location:
  • Phone: 786-206-6500
  • Fax: 786-206-4702
Mailing address:
  • Phone: 305-303-6631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH15187
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: