Provider Demographics
NPI:1275068538
Name:ACEVEDO GARCIA, YORDANKA
Entity Type:Individual
Prefix:
First Name:YORDANKA
Middle Name:
Last Name:ACEVEDO 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 1:14823 SW 171ST TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-1777
Mailing Address - Country:US
Mailing Address - Phone:786-343-0706
Mailing Address - Fax:
Practice Address - Street 1:9020 SW 137TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-1427
Practice Address - Country:US
Practice Address - Phone:786-615-9400
Practice Address - Fax:305-271-7949
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA15821224Z00000X
FLOT22559225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant