Provider Demographics
NPI:1992399661
Name:GARCIA, OTANYS
Entity Type:Individual
Prefix:
First Name:OTANYS
Middle Name:
Last Name:GARCIA
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 1:8031 W 36TH AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33018-1735
Mailing Address - Country:US
Mailing Address - Phone:786-306-6478
Mailing Address - Fax:
Practice Address - Street 1:8031 W 36TH AVE APT 6
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33018-1735
Practice Address - Country:US
Practice Address - Phone:786-306-6478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician