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NPI Code Detail

MEDICARE: KELLY MARIE GALLUZZI

MEDICARE: KELLY MARIE GALLUZZI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician
2103K00000XBehavior Analyst1-20-44527FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285177170
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY MARIE GALLUZZI
Provider Business Mailing Address
First Line : 32 PRICE LN
Second Line :
City : PALM COAST
State : FL
Zip : 32164-7417
Country : US
Telephone Number : 443-834-4785
Fax Number :
Provider Business Practice Location Address
First Line : 12724 GRAN BAY PARKWAY WEST
Second Line : SUITE 410
City : JACKSONVILLE
State : FL
Zip : 32258-9486
Country : US
Telephone Number : 855-832-6727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2016
Last Update Date : 04/21/2026

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Directions to “ KELLY MARIE GALLUZZI ” Practice Location

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