Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | ME81511 | FL |
NPI | 1003021825 |
---|---|
Provider Name | Dr. Gary Anthony Gallo |
First Address | Jacksonville, FL 32256-6017 |
Second Address | Naples, FL 34114-3549 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2007 |
Last Update Date | 30/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D02713 | (02) | FL |
HT920Z | (02) | FL |