Provider Demographics
NPI:1295160497
Name:GALARZA, XAVIER O (LND)
Entity type:Individual
Prefix:MR
First Name:XAVIER
Middle Name:O
Last Name:GALARZA
Suffix:
Gender:M
Credentials:LND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. BONNEVILLE VALLEY CALLE REY GASPAR #81
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00727
Mailing Address - Country:UM
Mailing Address - Phone:787-203-7870
Mailing Address - Fax:
Practice Address - Street 1:CARRETERA 14 KM 72.2 SECTOR LOMAS, BARRIO RINCON,
Practice Address - Street 2:HOSPITAL MENONITA CAYEY
Practice Address - City:CAYEY
Practice Address - State:PR
Practice Address - Zip Code:00736
Practice Address - Country:US
Practice Address - Phone:787-203-7870
Practice Address - Fax:787-263-1602
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1640133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered