Provider Demographics
NPI:1619072568
Name:GARCIA-LARRIEU, MARIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:GARCIA-LARRIEU
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1522 SAN IGNACIO AVE
Mailing Address - Street 2:STE. 1
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3029
Mailing Address - Country:US
Mailing Address - Phone:305-663-1600
Mailing Address - Fax:305-663-1633
Practice Address - Street 1:1522 SAN IGNACIO AVE
Practice Address - Street 2:STE. 1
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3029
Practice Address - Country:US
Practice Address - Phone:305-663-1600
Practice Address - Fax:305-663-1633
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6629103TC0700X
NY014054-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL54867ZMedicare ID - Type Unspecified