Provider Demographics
NPI:1689920415
Name:GALLUZZO, NINA D (CRNP)
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:D
Last Name:GALLUZZO
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 N STATE ROAD 7
Mailing Address - Street 2:STE 1
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33073-3354
Mailing Address - Country:US
Mailing Address - Phone:410-322-9465
Mailing Address - Fax:
Practice Address - Street 1:4450 N STATE ROAD 7
Practice Address - Street 2:STE 1
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33073-3354
Practice Address - Country:US
Practice Address - Phone:410-322-9465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR138016363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily