Provider Demographics
NPI:1821027921
Name:GALIANO, VINCENT (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:
Last Name:GALIANO
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 1:8031 PHILIPS HWY
Mailing Address - Street 2:#6
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-4451
Mailing Address - Country:US
Mailing Address - Phone:904-737-6313
Mailing Address - Fax:904-739-1302
Practice Address - Street 1:8031 PHILIPS HWY
Practice Address - Street 2:#6
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-4451
Practice Address - Country:US
Practice Address - Phone:904-737-6313
Practice Address - Fax:904-739-1302
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78889207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLH63788Medicare UPIN
FL03261Medicare ID - Type Unspecified