Provider Demographics
NPI:1790585230
Name:RIO GARCIA, LEGNA
Entity type:Individual
Prefix:
First Name:LEGNA
Middle Name:
Last Name:RIO GARCIA
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 1:11313 SW 74TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-2648
Mailing Address - Country:US
Mailing Address - Phone:786-257-6184
Mailing Address - Fax:
Practice Address - Street 1:11313 SW 74TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-2648
Practice Address - Country:US
Practice Address - Phone:786-257-6184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-14
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
FL171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator