Healthcare Provider Details

I. General information

NPI: 1568720779
Provider Name (Legal Business Name): HECTOR DAVID GALLEGO-SANCHEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2012
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 TECHNOLOGY PARK STE 109
LAKE MARY FL
32746-7107
US

IV. Provider business mailing address

525 TECHNOLOGY PARK STE 109
LAKE MARY FL
32746-7107
US

V. Phone/Fax

Practice location:
  • Phone: 407-647-2346
  • Fax:
Mailing address:
  • Phone: 407-647-2346
  • Fax: 318-212-6752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME140741
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: