Healthcare Provider Details

I. General information

NPI: 1073304614
Provider Name (Legal Business Name): TIFFANY GARCIA APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2025
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20824 W DIXIE HWY
MIAMI FL
33180-1147
US

IV. Provider business mailing address

6460 SW 120TH AVE
MIAMI FL
33183-2724
US

V. Phone/Fax

Practice location:
  • Phone: 305-654-0907
  • Fax:
Mailing address:
  • Phone: 954-683-3997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11039457
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: