Healthcare Provider Details

I. General information

NPI: 1790362861
Provider Name (Legal Business Name): GRABIELA GUTIERREZ GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2021
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14780 SW 176TH ST
MIAMI FL
33187-6714
US

IV. Provider business mailing address

14780 SW 176TH ST
MIAMI FL
33187-6714
US

V. Phone/Fax

Practice location:
  • Phone: 786-769-0735
  • Fax:
Mailing address:
  • Phone: 786-769-0735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-25-16546
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: