Provider Demographics
NPI:1487357331
Name:GARCIA, CARLA SELENE (PMHNP, APRN, RN)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:SELENE
Last Name:GARCIA
Suffix:
Gender:F
Credentials:PMHNP, APRN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3323 W 90TH TER
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-2007
Mailing Address - Country:US
Mailing Address - Phone:305-934-9850
Mailing Address - Fax:
Practice Address - Street 1:3250 MARY ST STE 300
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-5293
Practice Address - Country:US
Practice Address - Phone:305-908-1115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9540367163W00000X
FL11023858363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse