Provider Demographics
NPI:1225612567
Name:GALORE MEDICAL LLC
Entity Type:Organization
Organization Name:GALORE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHENIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESIR
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:305-418-0580
Mailing Address - Street 1:7522 WILES RD STE B201
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-2062
Mailing Address - Country:US
Mailing Address - Phone:954-488-2013
Mailing Address - Fax:305-402-0941
Practice Address - Street 1:7522 WILES RD STE B201
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-2062
Practice Address - Country:US
Practice Address - Phone:954-488-2013
Practice Address - Fax:305-402-0941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty