Provider Demographics
NPI:1407471568
Name:GARCIA GIRALDO, MARISBEL
Entity type:Individual
Prefix:
First Name:MARISBEL
Middle Name:
Last Name:GARCIA GIRALDO
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 1:2023 NW 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-3960
Mailing Address - Country:US
Mailing Address - Phone:786-694-4317
Mailing Address - Fax:
Practice Address - Street 1:2023 NW 14TH AVE
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-3960
Practice Address - Country:US
Practice Address - Phone:786-694-4317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-14
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106681200Medicaid