Provider Demographics
NPI:1205943602
Name:GALCERAN, MANUEL J (MD)
Entity type:Individual
Prefix:
First Name:MANUEL
Middle Name:J
Last Name:GALCERAN
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 1:5979 VINELAND RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7800
Mailing Address - Country:US
Mailing Address - Phone:407-345-0005
Mailing Address - Fax:407-352-8585
Practice Address - Street 1:5979 VINELAND RD
Practice Address - Street 2:SUITE 310
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7800
Practice Address - Country:US
Practice Address - Phone:407-345-0005
Practice Address - Fax:407-352-8585
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0038588207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D55058Medicare UPIN
FL47438UMedicare PIN
FL47438ZMedicare PIN