Provider Demographics
NPI:1831579473
Name:GARCIA MENDIOLA, NIURKA (BCBA)
Entity type:Individual
Prefix:
First Name:NIURKA
Middle Name:
Last Name:GARCIA MENDIOLA
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 NW 40TH CT
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-5745
Mailing Address - Country:US
Mailing Address - Phone:786-406-4353
Mailing Address - Fax:
Practice Address - Street 1:249 NW 40TH CT
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-5745
Practice Address - Country:US
Practice Address - Phone:786-406-4353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
00000000000000000000104100000X
106S00000X
FL1-20-46518103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109426900Medicaid