Provider Demographics
NPI:1982456968
Name:GALASSO, BIANCA GABRIELA
Entity Type:Individual
Prefix:MISS
First Name:BIANCA
Middle Name:GABRIELA
Last Name:GALASSO
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 1:11200 THREE RIVERS RD APT 10D
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-3581
Mailing Address - Country:US
Mailing Address - Phone:954-224-3554
Mailing Address - Fax:
Practice Address - Street 1:30 E. APPLE STREET
Practice Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE, 6TH FLOOR
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409
Practice Address - Country:US
Practice Address - Phone:954-224-3554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program