MEDICARE: GALENHEALTH MEDICAL CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker
2	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285383042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALENHEALTH MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	9685 LAKE NONA VILLAGE PL STE 204
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7322
Country	:	US
Telephone Number	:	321-888-2631
Fax Number	:	321-900-0012

Provider Business Practice Location Address
First Line	:	9685 LAKE NONA VILLAGE PL STE 204
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32827-7322
Country	:	US
Telephone Number	:	321-888-2631
Fax Number	:	321-900-0012

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	BENITA MONIZE
Credential	:	LCSW
Telephone Number	:	941-586-9688

Provider Enumeration Date	:	03/21/2022
Last Update Date	:	09/25/2023

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Directions to “GALENHEALTH MEDICAL CENTER LLC ” Practice Location

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