Healthcare Provider Details

I. General information

NPI: 1992955363
Provider Name (Legal Business Name): DANIEL GALLEGOS ANP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 S TUTTLE AVE
SARASOTA FL
34239-2608
US

IV. Provider business mailing address

157 BALTIMORE ST STE 102
CUMBERLAND MD
21502-2472
US

V. Phone/Fax

Practice location:
  • Phone: 301-722-0484
  • Fax: 833-903-0130
Mailing address:
  • Phone: 301-722-0484
  • Fax: 833-903-0130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP3383
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: