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General NPI Number Information
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NPI Number | 1225612567
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Entity Type | Organization
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Legal Business Name | GALORE MEDICAL LLC
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Dates
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Enumeration Date | 05/12/2021
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Last Update Date | 06/07/2022
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Provider Practice Location Address
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Address Line | 7522 WILES RD STE B201
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-2062
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Country | US
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Telephone | 954-488-2013
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Fax | 305-402-0941
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Provider Business Mailing Address
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Address Line | 7522 WILES RD STE B201
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-2062
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Country | US
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Telephone | 954-488-2013
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Fax | 305-402-0941
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Authorized Official
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Title or Position | OWNER
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Name | SHENIDA DESIR
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Credential | NP
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Telephone | 305-418-0580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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