Healthcare Provider Details

I. General information

NPI: 1699344168
Provider Name (Legal Business Name): ALEXANDER DANIEL GILROY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2021
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 BUDINGER AVE
SAINT CLOUD FL
34769-4140
US

IV. Provider business mailing address

1525 BUDINGER AVE
SAINT CLOUD FL
34769-4140
US

V. Phone/Fax

Practice location:
  • Phone: 770-869-2234
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0103301419
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO4677
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: