Provider Demographics
NPI:1003028804
Name:GARCIA, GERTRUDIS CLARA (MS)
Entity Type:Individual
Prefix:MRS
First Name:GERTRUDIS
Middle Name:CLARA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15681 SW 18TH LN
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-5819
Mailing Address - Country:US
Mailing Address - Phone:305-975-9884
Mailing Address - Fax:
Practice Address - Street 1:4800 W FLAGLER ST STE 215
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1402
Practice Address - Country:US
Practice Address - Phone:954-368-4786
Practice Address - Fax:954-368-4101
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-20-41101103K00000X
FLIMT 658106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist