Provider Demographics
NPI:1467022640
Name:GARCIA SANCHEZ, MAYTE (CBHCM-P)
Entity Type:Individual
Prefix:MS
First Name:MAYTE
Middle Name:
Last Name:GARCIA SANCHEZ
Suffix:
Gender:F
Credentials:CBHCM-P
Other - Prefix:
Other - First Name:MAYTE
Other - Middle Name:
Other - Last Name:GARCIA SANCHEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CBHCM-P
Mailing Address - Street 1:1820 W 46TH ST APT 405
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-2846
Mailing Address - Country:US
Mailing Address - Phone:786-537-7416
Mailing Address - Fax:
Practice Address - Street 1:1820 W 46TH ST APT 405
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2846
Practice Address - Country:US
Practice Address - Phone:786-537-7416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-29
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101671171M00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101671Medicaid