Provider Demographics
NPI:1609486448
Name:GARCIA, GETZABEL (GETZABEL)
Entity Type:Individual
Prefix:MRS
First Name:GETZABEL
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:GETZABEL
Other - Prefix:MRS
Other - First Name:GETZABEL
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:GETZABEL
Mailing Address - Street 1:304 58TH AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34203-6247
Mailing Address - Country:US
Mailing Address - Phone:941-241-6885
Mailing Address - Fax:
Practice Address - Street 1:304 58TH AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-6247
Practice Address - Country:US
Practice Address - Phone:941-241-6885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9613696679Medicaid