Healthcare Provider Details

I. General information

NPI: 1699420521
Provider Name (Legal Business Name): CORINA GALINDO JUAREZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2022
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4160 UNIVERSITY BLVD S
JACKSONVILLE FL
32216-4317
US

IV. Provider business mailing address

PO BOX 878
DAVENPORT FL
33836-0878
US

V. Phone/Fax

Practice location:
  • Phone: 904-861-1900
  • Fax: 904-861-1902
Mailing address:
  • Phone: 689-223-3798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number226583
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number226583
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN11026016
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: