Provider Demographics
NPI:1124216320
Name:LANDA-GALINDEZ MD PA
Entity Type:Organization
Organization Name:LANDA-GALINDEZ MD PA
Other - Org Name:LANDA-GALINDEZ MD PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMALIA
Authorized Official - Middle Name:MERCEDES
Authorized Official - Last Name:LANDA-GALINDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-668-5103
Mailing Address - Street 1:7600 SW 57TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SOUTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-5428
Mailing Address - Country:US
Mailing Address - Phone:305-668-5103
Mailing Address - Fax:305-668-5125
Practice Address - Street 1:7600 SW 57TH AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5428
Practice Address - Country:US
Practice Address - Phone:305-668-5103
Practice Address - Fax:305-668-5125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-12
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0069836207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1194712042Medicaid
FL1194712042Medicaid