Healthcare Provider Details

I. General information

NPI: 1134914997
Provider Name (Legal Business Name): ROSALEN GARCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2025
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7508 STILLRIDGE DR APT L
TAMPA FL
33615-1386
US

IV. Provider business mailing address

7508 STILLRIDGE DR APT L
TAMPA FL
33615-1386
US

V. Phone/Fax

Practice location:
  • Phone: 786-806-2604
  • Fax:
Mailing address:
  • Phone: 786-806-2604
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: