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NPI Code Detail

MEDICARE: MRS. DOREEN DALE GALL A.R.N.P.

MEDICARE: MRS. DOREEN DALE GALL A.R.N.P.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WH1000XHospice Registered Nurse3189902FL
2363LA2200XAdult Health Nurse Practitioner3189902FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053650507
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DOREEN DALE GALL A.R.N.P.
Provider Business Mailing Address
First Line : 6318 PLYMOUTH SORRENTO RD
Second Line :
City : APOPKA
State : FL
Zip : 32712-5162
Country : US
Telephone Number : 352-636-8042
Fax Number : 407-814-7759
Provider Business Practice Location Address
First Line : 7620 LAKE UNDERHILL RD
Second Line :
City : ORLANDO
State : FL
Zip : 32822-8223
Country : US
Telephone Number : 321-235-0692
Fax Number : 321-235-0694
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2013
Last Update Date : 12/16/2021

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