Basic Information
| Provider Information | |||||||||
| NPI: | 1114374188 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GALARZA | ||||||||
| FirstName: | JUAN | ||||||||
| MiddleName: | ANTONIO | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1515 E SILVER SPRINGS BLVD STE 217 | ||||||||
| Address2: | |||||||||
| City: | OCALA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 344706844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3527323333 | ||||||||
| FaxNumber: | 3527322469 | ||||||||
| Practice Location | |||||||||
| Address1: | 1695 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MA | ||||||||
| PostalCode: | 011031348 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4137395572 | ||||||||
| FaxNumber: | 4137399972 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/19/2016 | ||||||||
| LastUpdateDate: | 12/23/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/23/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.