Provider Demographics
NPI:1134914997
Name:GARCIA, ROSALEN
Entity type:Individual
Prefix:
First Name:ROSALEN
Middle Name:
Last Name:GARCIA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7508 STILLRIDGE DR APT L
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-1386
Mailing Address - Country:US
Mailing Address - Phone:786-806-2604
Mailing Address - Fax:
Practice Address - Street 1:7508 STILLRIDGE DR APT L
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-1386
Practice Address - Country:US
Practice Address - Phone:786-806-2604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral