Provider Demographics
NPI:1164662334
Name:GALDAMEZ, MAUREEN MCAULIFFE (PA-C)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:MCAULIFFE
Last Name:GALDAMEZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CAMELIA ST
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-4223
Mailing Address - Country:US
Mailing Address - Phone:850-453-6737
Mailing Address - Fax:850-453-1196
Practice Address - Street 1:6715 W HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-5923
Practice Address - Country:US
Practice Address - Phone:850-453-6737
Practice Address - Fax:850-453-1196
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002956363A00000X
FLPA9105369363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
592-10495OtherBCBSAL
FL002631200Medicaid
FLY03L1OtherBCBSFL
FL002631200Medicaid