Provider Demographics
NPI:1205291580
Name:GARCIA, YADIRA (BSW)
Entity type:Individual
Prefix:
First Name:YADIRA
Middle Name:
Last Name:GARCIA
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 LEOPARD CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-4313
Mailing Address - Country:US
Mailing Address - Phone:717-809-7872
Mailing Address - Fax:
Practice Address - Street 1:750 LEOPARD CT
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-4313
Practice Address - Country:US
Practice Address - Phone:717-809-7872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator