Provider Demographics
NPI:1487310322
Name:GARCIA CARDENAS, ISIET (LICENSE RBT)
Entity type:Individual
Prefix:
First Name:ISIET
Middle Name:
Last Name:GARCIA CARDENAS
Suffix:
Gender:F
Credentials:LICENSE RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 W 53RD ST APT 202
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2068
Mailing Address - Country:US
Mailing Address - Phone:786-447-6444
Mailing Address - Fax:
Practice Address - Street 1:11851 SW 213TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-5929
Practice Address - Country:US
Practice Address - Phone:786-447-6444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-15
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-21-190962106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLRBT-21-190962OtherLICENSE RBT