Active NPI
Roald Garcia, PSY.D.
- Clinical Psychologist
- Davie, FL
National Provider Identifier
1801963350
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY 7631
- Practice address
- 4801 S University Dr Ste 249
Davie, FL 33328-3836 - Phone
- (954) 680-8155
- Fax
- (954) 434-4530
- NPI assigned
- Nov 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PY 7631 | FL | Primary |
Addresses
Primary practice location
4801 S University Dr Ste 249
Davie, FL 33328-3836
Mailing address
4801 S University Dr Ste 249
Davie, FL 33328-3836
Phone (954) 680-8155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2021 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 7631 | FL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688947200000",
"number": "1801963350",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4801 S UNIVERSITY DR STE 249",
"city": "DAVIE",
"state": "FL",
"postal_code": "333283836",
"telephone_number": "954-680-8155",
"fax_number": "954-434-4530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4801 S UNIVERSITY DR STE 249",
"city": "DAVIE",
"state": "FL",
"postal_code": "333283836",
"telephone_number": "954-680-8155",
"fax_number": "954-434-4530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARCIA",
"first_name": "ROALD",
"name_prefix": "Mr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2023-07-10",
"certification_date": "2023-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "FL",
"license": "PY 7631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.