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General NPI Number Information
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NPI Number | 1477137990
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Entity Type | Individual
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Provider Name | ANDREA C. GARCIA VIDAL LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/11/2021
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Last Update Date | 05/11/2021
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Provider Practice Location Address
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Address Line | 3100 SW 62ND AVE
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City | MIAMI
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State | FL
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Zip | 33155-3009
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Country | US
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Telephone | 305-669-6503
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Fax |
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Provider Business Mailing Address
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Address Line | 2263 SW 37TH AVE APT 625
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City | MIAMI
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State | FL
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Zip | 33145-3267
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Country | US
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Telephone | 787-717-7312
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT4039
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License Number State | FL
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