Provider Demographics
NPI:1689836769
Name:GALEANO-RODRIGUEZ, CARLOS ALFONSO (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:ALFONSO
Last Name:GALEANO-RODRIGUEZ
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 1:106 GILSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-9763
Mailing Address - Country:US
Mailing Address - Phone:412-522-5549
Mailing Address - Fax:412-386-3838
Practice Address - Street 1:3601 SW 160TH AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-6308
Practice Address - Country:US
Practice Address - Phone:954-399-4642
Practice Address - Fax:877-859-8768
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD442454208D00000X, 207Q00000X
PAMT192374390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program