Provider Demographics
NPI:1245761329
Name:SOSA GARCIA, BELQUIS
Entity Type:Individual
Prefix:
First Name:BELQUIS
Middle Name:
Last Name:SOSA 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 1:4500 W 16TH AVE APT 412
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2910
Mailing Address - Country:US
Mailing Address - Phone:786-317-9746
Mailing Address - Fax:
Practice Address - Street 1:4500 W 16TH AVE APT 412
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2910
Practice Address - Country:US
Practice Address - Phone:786-317-9746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-21
Last Update Date:2021-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
FL0-21-11842106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst