Provider Demographics
NPI:1548906795
Name:GARCIA, ELIZABETH
Entity type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:
Last Name:GARCIA
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 1:5610 MARIGOLD WAY APT 307
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-2754
Mailing Address - Country:US
Mailing Address - Phone:239-273-2925
Mailing Address - Fax:
Practice Address - Street 1:5610 MARIGOLD WAY APT 307
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-2754
Practice Address - Country:US
Practice Address - Phone:239-273-2925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician