Basic Information
Provider Information
NPI: 1184252546
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GALVIS
FirstName: ADRIANA
MiddleName: DEL PILAR
NamePrefix: MRS.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 19255 SW 25TH CT
Address2:  
City: MIRAMAR
State: FL
PostalCode: 330292466
CountryCode: US
TelephoneNumber: 5613466708
FaxNumber:  
Practice Location
Address1: 12193 PEMBROKE RD
Address2:  
City: PEMBROKE PINES
State: FL
PostalCode: 330251727
CountryCode: US
TelephoneNumber: 9544358820
FaxNumber: 9544508185
Other Information
ProviderEnumerationDate: 03/31/2020
LastUpdateDate: 03/31/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/31/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
237700000XAS5331FLY Speech, Language and Hearing Service ProvidersHearing Instrument Specialist 

No ID Information.


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