Provider Demographics
NPI:1538996822
Name:GARCIA ALONSO, BARBARA LICETT
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:LICETT
Last Name:GARCIA ALONSO
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 1:10930 PEACHTREE DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-7638
Mailing Address - Country:US
Mailing Address - Phone:786-859-8522
Mailing Address - Fax:
Practice Address - Street 1:10930 PEACHTREE DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33161-7638
Practice Address - Country:US
Practice Address - Phone:786-859-8522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-19
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-377476106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty