Provider Demographics
NPI:1104019363
Name:GREELEY, GALE E (MD)
Entity Type:Individual
Prefix:
First Name:GALE
Middle Name:E
Last Name:GREELEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GALE
Other - Middle Name:GREELEY
Other - Last Name:KEMPNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 918025
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32891-8025
Mailing Address - Country:US
Mailing Address - Phone:352-265-5404
Mailing Address - Fax:352-376-6270
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-265-5404
Practice Address - Fax:352-376-6270
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2009-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME461432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279887500Medicaid
FL279887500Medicaid
30885XMedicare PIN