Provider Demographics
NPI:1659109965
Name:GALLAGHER, DARRIN (DO 7465)
Entity type:Individual
Prefix:
First Name:DARRIN
Middle Name:
Last Name:GALLAGHER
Suffix:
Gender:M
Credentials:DO 7465
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 RINEHART RD
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-7392
Mailing Address - Country:US
Mailing Address - Phone:407-321-1986
Mailing Address - Fax:
Practice Address - Street 1:1601 RINEHART RD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-7392
Practice Address - Country:US
Practice Address - Phone:407-321-1986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO7465156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician