Healthcare Provider Details

I. General information

NPI: 1598341950
Provider Name (Legal Business Name): MARIA GALARZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

937 NAPLES LN
ORANGE PARK FL
32065-6663
US

IV. Provider business mailing address

950 BLANDING BLVD STE 23
ORANGE PARK FL
32065-5912
US

V. Phone/Fax

Practice location:
  • Phone: 904-432-5365
  • Fax:
Mailing address:
  • Phone: 904-513-0112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code156F00000X
TaxonomyTechnician/Technologist
License Number159413
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number159413
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: