Basic Information
| Provider Information | |||||||||
| NPI: | 1821202862 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARCIA | ||||||||
| FirstName: | INGRID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | M.S ED | ||||||||
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| Mailing Information | |||||||||
| Address1: | 441 NE 119TH ST | ||||||||
| Address2: | |||||||||
| City: | BISCAYNE PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331616231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3053050958 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 11440 N KENDALL DR STE 109 | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331761024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3059298705 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/09/2007 | ||||||||
| LastUpdateDate: | 03/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 222Q00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist |
No ID Information.