Provider Demographics
NPI:1639852742
Name:GARCIA MORAN, MARILYS BEATRIZ (RBT)
Entity Type:Individual
Prefix:
First Name:MARILYS
Middle Name:BEATRIZ
Last Name:GARCIA MORAN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5893 FOLKSTONE LN
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-9416
Mailing Address - Country:US
Mailing Address - Phone:689-286-9923
Mailing Address - Fax:
Practice Address - Street 1:50 WILLOW DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-3220
Practice Address - Country:US
Practice Address - Phone:407-895-0801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-288895106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician