Healthcare Provider Details

I. General information

NPI: 1689196487
Provider Name (Legal Business Name): SOFIA CERVERA GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2017
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16341 SW 114TH CT
MIAMI FL
33157-2747
US

IV. Provider business mailing address

16341 SW 114TH CT
MIAMI FL
33157-2747
US

V. Phone/Fax

Practice location:
  • Phone: 305-587-8884
  • Fax:
Mailing address:
  • Phone: 305-587-8884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ11210
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-26-89359
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: