Provider Demographics
NPI:1508624438
Name:GARCIA CORDERO, HEILY
Entity Type:Individual
Prefix:
First Name:HEILY
Middle Name:
Last Name:GARCIA CORDERO
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 1:14901 SW 80TH ST APT 212
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-3134
Mailing Address - Country:US
Mailing Address - Phone:786-909-6132
Mailing Address - Fax:
Practice Address - Street 1:14901 SW 80TH ST APT 212
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33193-3134
Practice Address - Country:US
Practice Address - Phone:786-909-6132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician