Healthcare Provider Details

I. General information

NPI: 1609785377
Provider Name (Legal Business Name): ANA SOFIA GARCIA LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 NW 12TH AVE
MIAMI FL
33136-2140
US

IV. Provider business mailing address

1265 NW 12TH AVE
MIAMI FL
33136-2140
US

V. Phone/Fax

Practice location:
  • Phone: 786-744-6504
  • Fax:
Mailing address:
  • Phone: 786-744-6504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW26092
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: