Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | ME0075093 | FL |
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | ME0075093 | FL |
NPI | 1376552661 |
---|---|
Provider Name | Kenneth J Galang |
First Address | Fort Myers, FL 33919-0382 |
Second Address | Fort Myers, FL 33912-7144 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 12/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1631062002 | CIGNA HMO (01) | FL |
1823430 | UHC (01) | FL |
2025126 | AETNA HMO (01) | FL |
255349000 | (05) | FL |
44525 | BCBS (01) | FL |
5705641 | AETNA PPO (01) | FL |
592207264 | CIGNA PPO (01) | FL |
592207264E | HUMANA (01) | FL |
G46942 | (02) | FL |