Healthcare Provider Details

I. General information

NPI: 1417849423
Provider Name (Legal Business Name): CATALINA RAE GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2025
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 MILLENIA BLVD
ORLANDO FL
32839-6012
US

IV. Provider business mailing address

7225 WINDOVER WAY
TITUSVILLE FL
32780-7555
US

V. Phone/Fax

Practice location:
  • Phone: 407-264-5601
  • Fax:
Mailing address:
  • Phone: 321-289-5715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: