MEDICARE: DR. AILEEN GARCIAGAYOSO MD

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	207R00000X	Internal Medicine Physician	15680	MS
2	207R00000X	Internal Medicine Physician	35751	TN

General Provider Information

NPI Number	:	1891757761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AILEEN GARCIAGAYOSO MD

Provider Business Mailing Address
First Line	:	PO BOX 1000
Second Line	:	DEPT 311
City	:	MEMPHIS
State	:	TN
Zip	:	38148-0001
Country	:	US
Telephone Number	:	901-569-0519
Fax Number	:

Provider Business Practice Location Address
First Line	:	1325 EASTMORELAND AVE
Second Line	:	SUITE 445
City	:	MEMPHIS
State	:	TN
Zip	:	38104-3519
Country	:	US
Telephone Number	:	901-569-0519
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2006
Last Update Date	:	04/17/2023

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