Provider Demographics
NPI:1164703583
Name:GARCIA, LINETTE M (MS-SLP)
Entity Type:Individual
Prefix:
First Name:LINETTE
Middle Name:M
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MS-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1251 NW 126TH AVE
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-3125
Mailing Address - Country:US
Mailing Address - Phone:954-534-3463
Mailing Address - Fax:
Practice Address - Street 1:1251 NW 126TH AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-3125
Practice Address - Country:US
Practice Address - Phone:954-534-3463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ 5537235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist