Healthcare Provider Details

I. General information

NPI: 1487983276
Provider Name (Legal Business Name): MARIA GALANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2009
Last Update Date: 12/08/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13710 METROPOLIS AVE UNIT 110
FORT MYERS FL
33912-7144
US

IV. Provider business mailing address

PO BOX 07382
FORT MYERS FL
33919-0382
US

V. Phone/Fax

Practice location:
  • Phone: 239-225-0129
  • Fax: 239-225-0575
Mailing address:
  • Phone: 239-225-0129
  • Fax: 239-225-0575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT0006118
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: