Provider Demographics
NPI:1386513109
Name:GARCIA GUTIERREZ, JOEL ALEJANDRO
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:ALEJANDRO
Last Name:GARCIA GUTIERREZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19800 SW 180TH AVE # LOTE411
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33187-2619
Mailing Address - Country:US
Mailing Address - Phone:305-497-2833
Mailing Address - Fax:
Practice Address - Street 1:19800 SW 180TH AVE # LOTE411
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33187-2619
Practice Address - Country:US
Practice Address - Phone:305-497-2833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-486605106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician