Provider Demographics
NPI:1861485260
Name:GALDA, CARMEN REGINA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:CARMEN
Middle Name:REGINA
Last Name:GALDA
Suffix:
Gender:F
Credentials:ARNP
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 36
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34605-0036
Mailing Address - Country:US
Mailing Address - Phone:352-346-5949
Mailing Address - Fax:352-848-3058
Practice Address - Street 1:26 E LIBERTY ST
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-2910
Practice Address - Country:US
Practice Address - Phone:352-848-3068
Practice Address - Fax:352-848-3058
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2152422363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL302677900Medicaid
FLE1379YMedicare ID - Type Unspecified
S655553Medicare UPIN