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General NPI Number Information
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NPI Number | 1902060601
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Entity Type | Organization
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Legal Business Name | DOMINGO E GALLIANO JR PA
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 08/27/2013
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Provider Practice Location Address
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Address Line | 18308 MURDOCK CIRCLE 108 DOMINGO E GALLIANO JR MD PA
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948
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Country | US
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Telephone | 941-625-1033
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Fax | 941-625-1792
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Provider Business Mailing Address
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Address Line | 18308 MURDOCK CIRCLE 108 DOMINGO E GALLIANO JR MD PA
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City | PORT CHARLOTTE
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State | FL
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Zip | 33948
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Country | US
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Telephone | 941-625-1033
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Fax | 941-625-1792
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOMINGO E GALLIANO
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Credential | MD
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Telephone | 941-625-1033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME54294
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | ME54294
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | ME54294
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License Number State | FL
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