Provider Demographics
NPI:1033701461
Name:GARCIA, MIKELA MONIKA
Entity Type:Individual
Prefix:
First Name:MIKELA
Middle Name:MONIKA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12595 SW 137TH AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-4222
Mailing Address - Country:US
Mailing Address - Phone:786-219-0151
Mailing Address - Fax:786-219-3920
Practice Address - Street 1:12595 SW 137TH AVE STE 305
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-4222
Practice Address - Country:US
Practice Address - Phone:786-219-0151
Practice Address - Fax:786-219-3920
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI47032355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant