Provider Demographics
NPI:1851749428
Name:GARCIA, NESTOR (RBT 1505324)
Entity Type:Individual
Prefix:
First Name:NESTOR
Middle Name:
Last Name:GARCIA
Suffix:
Gender:M
Credentials:RBT 1505324
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 W 74TH ST APT 203
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33014-4637
Mailing Address - Country:US
Mailing Address - Phone:786-302-8367
Mailing Address - Fax:
Practice Address - Street 1:1060 W 74TH ST APT 203
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33014-4637
Practice Address - Country:US
Practice Address - Phone:786-302-8367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-24
Last Update Date:2016-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT 1505324103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT 1505324OtherBACB