Provider Demographics
NPI:1750007548
Name:GARCIA, KARINA LUANNIE
Entity type:Individual
Prefix:
First Name:KARINA
Middle Name:LUANNIE
Last Name:GARCIA
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 1:2957 W SR 434 STE 100
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-4453
Mailing Address - Country:US
Mailing Address - Phone:407-271-4911
Mailing Address - Fax:321-284-8005
Practice Address - Street 1:2957 W SR 434 STE 100
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32779-4453
Practice Address - Country:US
Practice Address - Phone:407-271-4911
Practice Address - Fax:321-284-8005
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-13
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ11054235Z00000X
FLSA21674235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty