Provider Demographics
NPI:1346120144
Name:GARCIA PEREZ, XAVIER A
Entity type:Individual
Prefix:
First Name:XAVIER
Middle Name:A
Last Name:GARCIA PEREZ
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 1:3601 W 12TH AVE APT 21
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4965
Mailing Address - Country:US
Mailing Address - Phone:321-474-3330
Mailing Address - Fax:
Practice Address - Street 1:3601 W 12TH AVE APT 21
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4965
Practice Address - Country:US
Practice Address - Phone:239-406-2366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-25-469386106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician