Provider Demographics
NPI:1790768463
Name:CONSTANTE, GALO F (MD)
Entity Type:Individual
Prefix:
First Name:GALO
Middle Name:F
Last Name:CONSTANTE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:12400 BRANTLEY COMMONS CT
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33907-5677
Mailing Address - Country:US
Mailing Address - Phone:239-275-9040
Mailing Address - Fax:239-275-9070
Practice Address - Street 1:12400 BRANTLEY COMMONS CT
Practice Address - Street 2:SUITE 1
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5663
Practice Address - Country:US
Practice Address - Phone:239-275-9040
Practice Address - Fax:239-275-9070
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-27
Last Update Date:2016-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME83307207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262375700Medicaid
FL262375700Medicaid
FL03297AMedicare ID - Type Unspecified