Healthcare Provider Details

I. General information

NPI: 1730915885
Provider Name (Legal Business Name): MALVIZ GARCIA VARGAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 N RIDGEWOOD DR
SEBRING FL
33870-7205
US

IV. Provider business mailing address

3915 ALMERIA AVE
SEBRING FL
33872-2304
US

V. Phone/Fax

Practice location:
  • Phone: 863-576-9091
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: