Provider Demographics
NPI:1053752410
Name:GARCIA, ROSANNA MARIE (MOTR/L, LMT, CLT)
Entity type:Individual
Prefix:
First Name:ROSANNA
Middle Name:MARIE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:MOTR/L, LMT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 ATLANTIC SHORES BLVD
Mailing Address - Street 2:#309
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-1107
Mailing Address - Country:US
Mailing Address - Phone:786-253-8818
Mailing Address - Fax:
Practice Address - Street 1:1350 ATLANTIC SHORES BLVD
Practice Address - Street 2:#309
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-1107
Practice Address - Country:US
Practice Address - Phone:786-253-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-15
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 46803225700000X
FLOT 15821225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1053752410OtherN/A