Basic Information
Provider Information
NPI: 1225670946
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GALIANO RODRIGUEZ
FirstName: YAMILYS
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6900 TAVISTOCK LAKES BLVD STE 300
Address2:  
City: ORLANDO
State: FL
PostalCode: 328277592
CountryCode: US
TelephoneNumber: 3213326947
FaxNumber: 4072864515
Practice Location
Address1: 780 BUENAVENTURA BLVD
Address2:  
City: KISSIMMEE
State: FL
PostalCode: 347438128
CountryCode: US
TelephoneNumber: 4072749590
FaxNumber: 4073449971
Other Information
ProviderEnumerationDate: 10/14/2019
LastUpdateDate: 08/11/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/11/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X11003818FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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