Provider Demographics
NPI:1255830295
Name:GARCIA, NOHABI
Entity Type:Individual
Prefix:MISS
First Name:NOHABI
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:PO BOX 516
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33970-0516
Mailing Address - Country:US
Mailing Address - Phone:239-940-7112
Mailing Address - Fax:239-491-2113
Practice Address - Street 1:8411 HERON POND DR APT B110
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33972-8548
Practice Address - Country:US
Practice Address - Phone:239-940-7112
Practice Address - Fax:239-491-2113
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-05
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLG620-620-79-886-0171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG620-620-79886-0OtherFL DL