Provider Demographics
NPI:1669033858
Name:REYES GALARZA, DEBORA LIZ
Entity Type:Individual
Prefix:DR
First Name:DEBORA
Middle Name:LIZ
Last Name:REYES 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 1:1-30 PALACIOS DEL ESCORIAL
Mailing Address - Street 2:AVE DE DIEGO
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00987
Mailing Address - Country:US
Mailing Address - Phone:787-214-1759
Mailing Address - Fax:
Practice Address - Street 1:1-30 PALACIOS DEL ESCORIAL
Practice Address - Street 2:AVE DE DIEGO
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00987
Practice Address - Country:US
Practice Address - Phone:787-214-1759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PR3387122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program