Provider Demographics
NPI:1699446161
Name:GALIANO, DAMARIS (CRDH)
Entity type:Individual
Prefix:
First Name:DAMARIS
Middle Name:
Last Name:GALIANO
Suffix:
Gender:F
Credentials:CRDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 NW 83RD TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33150-2708
Mailing Address - Country:US
Mailing Address - Phone:305-788-4810
Mailing Address - Fax:
Practice Address - Street 1:3510 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3840
Practice Address - Country:US
Practice Address - Phone:305-576-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH29040124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist