Provider Demographics
NPI:1205109725
Name:GARCIA, MAYRA CABRERA (LMT)
Entity type:Individual
Prefix:
First Name:MAYRA
Middle Name:CABRERA
Last Name:GARCIA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6955 NW 77TH AVE
Mailing Address - Street 2:SUITE303
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-2852
Mailing Address - Country:US
Mailing Address - Phone:305-888-8550
Mailing Address - Fax:305-888-8556
Practice Address - Street 1:6955 NW 77TH AVE
Practice Address - Street 2:SUITE303
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-2852
Practice Address - Country:US
Practice Address - Phone:305-888-8550
Practice Address - Fax:305-888-8556
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA60375261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation