Provider Demographics
NPI:1477090918
Name:FERNANDO A. GALEANO D.D.S., P.A.
Entity Type:Organization
Organization Name:FERNANDO A. GALEANO D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FERNANDO
Authorized Official - Middle Name:ALFREDO
Authorized Official - Last Name:GALEANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-855-8505
Mailing Address - Street 1:150 PINE AVE N
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-4681
Mailing Address - Country:US
Mailing Address - Phone:813-855-8505
Mailing Address - Fax:813-855-7307
Practice Address - Street 1:150 PINE AVE N
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-4681
Practice Address - Country:US
Practice Address - Phone:813-855-8505
Practice Address - Fax:813-855-7307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-23
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN13066122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty