Provider Demographics
NPI:1285383042
Name:GALENHEALTH MEDICAL CENTER LLC
Entity type:Organization
Organization Name:GALENHEALTH MEDICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:BENITA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONIZE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:941-586-9688
Mailing Address - Street 1:9685 LAKE NONA VILLAGE PL STE 204
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7322
Mailing Address - Country:US
Mailing Address - Phone:321-888-2631
Mailing Address - Fax:321-900-0012
Practice Address - Street 1:9685 LAKE NONA VILLAGE PL STE 204
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32827-7322
Practice Address - Country:US
Practice Address - Phone:321-888-2631
Practice Address - Fax:321-900-0012
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-21
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty