Provider Demographics
NPI:1558902205
Name:GARCIGA, ORLANDO ANTONIO
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:ANTONIO
Last Name:GARCIGA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11223 NW 3RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-3528
Mailing Address - Country:US
Mailing Address - Phone:786-484-6682
Mailing Address - Fax:
Practice Address - Street 1:15520 NW 77TH CT REAR
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5804
Practice Address - Country:US
Practice Address - Phone:305-821-3023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL02333000Medicaid