Healthcare Provider Details

I. General information

NPI: 1528832706
Provider Name (Legal Business Name): KLENCI CANGAS GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2023
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5445 PARK CENTRAL CT
NAPLES FL
34109-6004
US

IV. Provider business mailing address

5883 OPPORTUNITY CIR UNIT 501
NAPLES FL
34112-3064
US

V. Phone/Fax

Practice location:
  • Phone: 239-304-8900
  • Fax: 239-692-8557
Mailing address:
  • Phone: 239-601-8178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-26-17076
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: