DOMINGO E GALLIANO JR PA
Osteopathic Medicine in Port Charlotte, FL

License number
Florida ME54294
Category
Radiology
Type
Surgery
License number
Florida ME54294
Category
Radiology
Type
Surgical Critical Care
License number
Florida ME54294
Category
Osteopathic Medicine
Type
Colon & Rectal Surgery
Owner
Name: DR. DOMINGO E GALLIANO MD
Title: OWNER
Phone: (941) 625-1033
Address
Address
18308 Domingo E GALLIANO JR MD PA, Port Charlotte, FL 33948
National Provider ID: 1902060601
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DOMINGO E. GALLIANO, JR., PA

Port Charlotte, FL

Status:
Inactive
Inactive reason:
NAME CHANGE AMENDMENT
Registration:
Feb 10, 1997
Inactive since:
Aug 28, 2013
Addresses:
18308 Murdock Cir, Port Charlotte, FL 33948 (Physical)
2525 Hbr Blvd, Port Charlotte, FL 33952
State ID:
P97000013162
Business type:
Florida Profit Corporation
Director:
Domingo Ejr Galliano (Director), 2349 St David Is Ct, Punta Gorda, FL 33950 (Physical)
Agent:
Domingo Galliano,2349 St David Is Ct, Punta Gorda, FL 33950 (Physical)
EIN:
65-0720209

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