Provider Demographics
NPI:1629276167
Name:GALARZA, JOSE L (MD, MPH)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:L
Last Name:GALARZA
Suffix:
Gender:M
Credentials:MD, MPH
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 151
Mailing Address - Street 2:
Mailing Address - City:ANGELES
Mailing Address - State:PR
Mailing Address - Zip Code:00611-0151
Mailing Address - Country:US
Mailing Address - Phone:787-764-3670
Mailing Address - Fax:787-765-5888
Practice Address - Street 1:C14 CALLE DOMENECH
Practice Address - Street 2:URB SIERRA BERDECIA
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00969-6225
Practice Address - Country:US
Practice Address - Phone:787-764-3670
Practice Address - Fax:787-765-5888
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003714102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst