Provider Demographics
NPI:1801677133
Name:GALARRAGA, LISBET
Entity type:Individual
Prefix:
First Name:LISBET
Middle Name:
Last Name:GALARRAGA
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 1:2901 E IRLO BRONSON MEMORIAL HWY STE D
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34744-5600
Mailing Address - Country:US
Mailing Address - Phone:140-748-3475
Mailing Address - Fax:407-201-6260
Practice Address - Street 1:2901 E IRLO BRONSON MEMORIAL HWY STE D
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34744-5600
Practice Address - Country:US
Practice Address - Phone:140-748-3475
Practice Address - Fax:407-201-6260
Is Sole Proprietor?:No
Enumeration Date:2023-10-12
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker