Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 60654 | CA |
NPI | 1003105628 |
---|---|
Provider Name | Dr. Carmen Galea |
First Address | Tampa, FL 33621-5023 |
Second Address | Tampa, FL 33621-5023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2011 |
Last Update Date | 11/03/2019 |