Healthcare Provider Details

I. General information

NPI: 1043785504
Provider Name (Legal Business Name): MICHELE GALANTI PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2018
Last Update Date: 10/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1213 BAY PINE BLVD
INDIAN ROCKS BEACH FL
33785-2837
US

IV. Provider business mailing address

1213 BAY PINE BLVD
INDIAN ROCKS BEACH FL
33785-2837
US

V. Phone/Fax

Practice location:
  • Phone: 727-692-9478
  • Fax:
Mailing address:
  • Phone: 727-692-9478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5699
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: