Basic Information
| Provider Information | |||||||||
| NPI: | 1306385737 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GALAY FLORES | ||||||||
| FirstName: | MELANIE | ||||||||
| MiddleName: | JANICE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1463 OAKFIELD DR STE 130 | ||||||||
| Address2: | |||||||||
| City: | BRANDON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 335110802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8136554166 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9051 FLORIDA MINING BLVD STE 102 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336341240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8003564049 | ||||||||
| FaxNumber: | 9414850519 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2017 | ||||||||
| LastUpdateDate: | 11/09/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 222Q00000X | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist | 106S00000X | RBT-20-142414 | FL | Y | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor |
No ID Information.