Provider Demographics
NPI:1558314435
Name:TRESGALLO, FRANK (MD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:TRESGALLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10569
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32120-0569
Mailing Address - Country:US
Mailing Address - Phone:386-274-7952
Mailing Address - Fax:
Practice Address - Street 1:8300 COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34114-3549
Practice Address - Country:US
Practice Address - Phone:239-354-6000
Practice Address - Fax:239-354-6098
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI13100207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI56299309Medicaid
HIA018OtherTRICARE
HI56299301Medicaid
HI56299308Medicaid
HI56299309Medicaid
HI56299301Medicaid