Provider Demographics
NPI:1740094838
Name:GARCIA VALLADARES, ERIK
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:
Last Name:GARCIA VALLADARES
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 1:8365 SW 152ND AVE UNIT C
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-4082
Mailing Address - Country:US
Mailing Address - Phone:954-268-0347
Mailing Address - Fax:
Practice Address - Street 1:12929 SW 59TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-1233
Practice Address - Country:US
Practice Address - Phone:786-695-4120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-410288106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician