Provider Demographics
NPI:1417451873
Name:TAMPA BAY ORTHOPEDIC SURGERY GROUP
Entity Type:Organization
Organization Name:TAMPA BAY ORTHOPEDIC SURGERY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLOWAY
Authorized Official - Suffix:III
Authorized Official - Credentials:DC
Authorized Official - Phone:813-420-3822
Mailing Address - Street 1:1100 W KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-1966
Mailing Address - Country:US
Mailing Address - Phone:813-253-3111
Mailing Address - Fax:
Practice Address - Street 1:1100 W KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-1966
Practice Address - Country:US
Practice Address - Phone:813-258-6051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty