Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 003325 | FL |
Y | 2251X0800X | Physical Therapist - Orthopedic | 003325 | FL |
NPI | 1104090364 |
---|---|
Provider Name | Dr. Robert Stuart Gailey JR. |
First Address | Miami, FL 33156-6013 |
Second Address | Miami, FL 33156-6013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2008 |
Last Update Date | 18/04/2008 |