Provider Demographics
NPI:1205803426
Name:GALAN, LAURA S II
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:S
Last Name:GALAN
Suffix:II
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:PO BOX 842
Mailing Address - Street 2:
Mailing Address - City:GOLDENROD
Mailing Address - State:FL
Mailing Address - Zip Code:32733-0842
Mailing Address - Country:US
Mailing Address - Phone:407-310-9005
Mailing Address - Fax:407-679-3878
Practice Address - Street 1:1200 TISDALL CT
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-5867
Practice Address - Country:US
Practice Address - Phone:407-310-9005
Practice Address - Fax:407-679-3878
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor