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General NPI Number Information
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NPI Number | 1851197230
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Entity Type | Individual
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Provider Name | RAYDALIS DE LA VICTORES GARCIA
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Gender | Female
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 500 S AUSTRALIAN AVE STE 600
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-6237
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Country | US
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Telephone | 877-857-8517
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Fax |
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Provider Business Mailing Address
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Address Line | 2352 SCHALL CIR
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-3002
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Country | US
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Telephone | 561-420-5729
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-414409
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License Number State | FL
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