Healthcare Provider Details

I. General information

NPI: 1346927316
Provider Name (Legal Business Name): ANGELICA GALBAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 04/29/2024
Certification Date: 04/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14400 NW 77TH CT
MIAMI LAKES FL
33016-1589
US

IV. Provider business mailing address

15935 SW 82ND ST
MIAMI FL
33193-3087
US

V. Phone/Fax

Practice location:
  • Phone: 305-653-5155
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ11073
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number22437
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: