MEDICARE: CARMEN GALAN

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
1	363LF0000X	Family Nurse Practitioner	11008422	FL

General Provider Information

NPI Number	:	1730792979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARMEN GALAN

Provider Business Mailing Address
First Line	:	561 SW 71ST PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2753
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	561 SW 71ST PL
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33144-2753
Country	:	US
Telephone Number	:	786-443-4861
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/27/2020
Last Update Date	:	08/27/2020

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Directions to “ CARMEN GALAN ” Practice Location

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