Provider Demographics
NPI:1225736838
Name:GARCIA, EVERLIN
Entity Type:Individual
Prefix:
First Name:EVERLIN
Middle Name:
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 1:1545 LAKE CRYSTAL DR APT E
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-2066
Mailing Address - Country:US
Mailing Address - Phone:786-226-4172
Mailing Address - Fax:
Practice Address - Street 1:1545 LAKE CRYSTAL DR APT E
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-2066
Practice Address - Country:US
Practice Address - Phone:786-226-4172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT23-258801106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician