Provider Demographics
NPI:1376598557
Name:GALLAGHER, JOSEPH WILLIAM (DO)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:WILLIAM
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:250 N ALAFAYA TRL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32828-4315
Mailing Address - Country:US
Mailing Address - Phone:407-282-4400
Mailing Address - Fax:407-282-4191
Practice Address - Street 1:250 N ALAFAYA TRL
Practice Address - Street 2:SUITE 100
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4315
Practice Address - Country:US
Practice Address - Phone:407-282-4400
Practice Address - Fax:407-282-4191
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS4192207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL82347OtherBCBS
FL82347OtherBCBS
E32212Medicare UPIN