Provider Demographics
NPI:1477351856
Name:GARCIA HERNANDEZ, VIOLETA MARION
Entity type:Individual
Prefix:
First Name:VIOLETA
Middle Name:MARION
Last Name:GARCIA HERNANDEZ
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 1:4206 EASTGATE DR APT 1407
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32839-2845
Mailing Address - Country:US
Mailing Address - Phone:786-320-2159
Mailing Address - Fax:
Practice Address - Street 1:4206 EASTGATE DR APT 1407
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32839-2845
Practice Address - Country:US
Practice Address - Phone:786-320-2159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLBACB1088814103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst