Healthcare Provider Details

I. General information

NPI: 1104662519
Provider Name (Legal Business Name): JORDAN LEIGH GALILI APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2024
Last Update Date: 10/14/2025
Certification Date: 10/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CELEBRATION PL STE 200
CELEBRATION FL
34747-5432
US

IV. Provider business mailing address

10134 BRANDON CIR
ORLANDO FL
32836-3717
US

V. Phone/Fax

Practice location:
  • Phone: 407-303-4220
  • Fax: 407-303-4676
Mailing address:
  • Phone: 407-620-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9522404
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11034042
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: