Provider Demographics
NPI:1598341950
Name:GALARZA, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:GALARZA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 BLANDING BLVD STE 23
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-5912
Mailing Address - Country:US
Mailing Address - Phone:904-513-0112
Mailing Address - Fax:
Practice Address - Street 1:937 NAPLES LN
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32065-6663
Practice Address - Country:US
Practice Address - Phone:904-432-5365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR159413156F00000X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
No156F00000XEye and Vision Services ProvidersTechnician/Technologist