Healthcare Provider Details

I. General information

NPI: 1255206280
Provider Name (Legal Business Name): MAYLIN GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20424 SW 5TH ST
PEMBROKE PINES FL
33029-5029
US

IV. Provider business mailing address

20424 SW 5TH ST
PEMBROKE PINES FL
33029-5029
US

V. Phone/Fax

Practice location:
  • Phone: 954-604-4134
  • Fax:
Mailing address:
  • Phone: 954-604-4134
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberAPRN11042285
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11042285
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: