Provider Demographics
NPI:1649654161
Name:IDALMYS GARCIA
Entity type:Organization
Organization Name:IDALMYS GARCIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:IDALMYS
Authorized Official - Middle Name:
Authorized Official - Last Name:GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-316-9810
Mailing Address - Street 1:3620 22ND AVE NE
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-5576
Mailing Address - Country:US
Mailing Address - Phone:239-316-9810
Mailing Address - Fax:
Practice Address - Street 1:3620 22ND AVE NE
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-5576
Practice Address - Country:US
Practice Address - Phone:239-316-9810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-14
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 106S00000X
FL385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No385H00000XRespite Care FacilityRespite Care