Healthcare Provider Details

I. General information

NPI: 1316408131
Provider Name (Legal Business Name): BEACHES BEHAVIORAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4141 SOUTHPOINT DR E STE A
JACKSONVILLE FL
32216-8061
US

IV. Provider business mailing address

PO BOX 51507
JACKSONVILLE BEACH FL
32240-1507
US

V. Phone/Fax

Practice location:
  • Phone: 904-853-5900
  • Fax: 904-853-5885
Mailing address:
  • Phone: 904-853-5900
  • Fax: 904-853-5885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: ALINA MARIA GALLIANO-PARDO
Title or Position: MD/PRESIDENT
Credential: MD
Phone: 904-853-5900