Healthcare Provider Details

I. General information

NPI: 1508450354
Provider Name (Legal Business Name): JAZMIN CARIDAD GALBAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2021
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24966 SW 107TH AVE
HOMESTEAD FL
33032-6336
US

IV. Provider business mailing address

24966 SW 107TH AVE
HOMESTEAD FL
33032-6336
US

V. Phone/Fax

Practice location:
  • Phone: 786-286-4714
  • Fax:
Mailing address:
  • Phone: 786-286-4714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-86431
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: