Healthcare Provider Details

I. General information

NPI: 1144158981
Provider Name (Legal Business Name): MAX GALLAGLY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

991 E DEL WEBB BLVD
SUN CITY CENTER FL
33573-6669
US

IV. Provider business mailing address

11631 CARROLLWOOD DR
TAMPA FL
33618-3713
US

V. Phone/Fax

Practice location:
  • Phone: 813-978-9700
  • Fax:
Mailing address:
  • Phone: 813-368-2015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: