MEDICARE: MARYIN GARCIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	G619-579-29-700-0	FL

General Provider Information

NPI Number	:	1770374597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYIN GARCIA

Provider Business Mailing Address
First Line	:	4907 VINCENNES ST APT 6
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-9149
Country	:	US
Telephone Number	:	786-631-2351
Fax Number	:	786-312-3516

Provider Business Practice Location Address
First Line	:	4907 VINCENNES ST APT 6
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33904-9149
Country	:	US
Telephone Number	:	786-631-2351
Fax Number	:	786-631-2351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2025
Last Update Date	:	05/13/2025

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Directions to “ MARYIN GARCIA ” Practice Location

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