Provider Demographics
NPI:1326299710
Name:GARCIA-DEROSE, MARIA ESTHER (BACHELOR OF SCIENCE)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ESTHER
Last Name:GARCIA-DEROSE
Suffix:
Gender:F
Credentials:BACHELOR OF SCIENCE
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:ESTHER
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:15818 SW WARFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:INDIANTOWN
Mailing Address - State:FL
Mailing Address - Zip Code:34956-3513
Mailing Address - Country:US
Mailing Address - Phone:772-597-0411
Mailing Address - Fax:772-597-0412
Practice Address - Street 1:15818 SW WARFIELD BLVD
Practice Address - Street 2:
Practice Address - City:INDIANTOWN
Practice Address - State:FL
Practice Address - Zip Code:34956-3513
Practice Address - Country:US
Practice Address - Phone:772-597-0411
Practice Address - Fax:772-597-0412
Is Sole Proprietor?:No
Enumeration Date:2008-10-04
Last Update Date:2008-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
N/A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker