Provider Demographics
NPI:1073540993
Name:GALLIANO-PARDO, ALINA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ALINA
Middle Name:M
Last Name:GALLIANO-PARDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 51507
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32240-1507
Mailing Address - Country:US
Mailing Address - Phone:904-853-5900
Mailing Address - Fax:904-853-5885
Practice Address - Street 1:4141 SOUTHPOINT DR E STE A
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-8061
Practice Address - Country:US
Practice Address - Phone:904-853-9000
Practice Address - Fax:904-853-5885
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1090032084P0800X
GA0564432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA445547410CMedicaid
FL003427500Medicaid
GA445547410DMedicaid
GA445547410DMedicaid
GA445547410CMedicaid
GA26BDKMDMedicare ID - Type Unspecified