Provider Demographics
NPI:1770912495
Name:GALOPIN, KEVIN (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:GALOPIN
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 58TH AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32966-4675
Mailing Address - Country:US
Mailing Address - Phone:321-307-6850
Mailing Address - Fax:
Practice Address - Street 1:1820 58TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32966-4675
Practice Address - Country:US
Practice Address - Phone:321-307-6850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-04
Last Update Date:2022-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ007321Medicaid