=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578134029
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MARIBEL GARCIA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2021
-----------------------------------------------------
Last Update Date | 07/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8648 NW 2ND TER STE 118
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33126-8309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 980-900-7876
-----------------------------------------------------
Fax | 786-391-2357
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8648 NW 2ND TER STE 118
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33126-8309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 980-900-7876
-----------------------------------------------------
Fax | 786-391-2357
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | CBHCMS.0102683
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | CBHCM.0104547
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------