Provider Demographics
NPI:1366028623
Name:GALARZA-ACEVEDO, LORAINNE MARIE (RN)
Entity Type:Individual
Prefix:
First Name:LORAINNE
Middle Name:MARIE
Last Name:GALARZA-ACEVEDO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14934 N FLORIDA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-1632
Mailing Address - Country:US
Mailing Address - Phone:813-991-4996
Mailing Address - Fax:813-269-2955
Practice Address - Street 1:14934 N FLORIDA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-1632
Practice Address - Country:US
Practice Address - Phone:813-991-4996
Practice Address - Fax:813-269-2955
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-18
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TR0400X
FL9488052163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitationGroup - Multi-Specialty