Manuel Gallego MD PA

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

MH0004146 Issued in FL

Legal business name

MANUEL GALLEGO MD PA

Practice address

3466 Depew Ave
Port Charlotte, FL 33952-7015

Phone

(941) 764-6300

Fax

(941) 764-7297

NPI assigned

Apr 17, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Prof. Lynne Parker Gallego, MBA

Title

Administrator

Phone

(941) 764-6300

Specialties & licenses 2

Addresses

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Adair Lynne Deicke

  • Psychiatric/Mental Health Nurse Practitioner
  • Sarasota, FL
  • NPI 1922185628
  NPD (past)
• Sharon Hart, ARNP

  • Adult Psychiatric/Mental Health Registered Nurse
  • Naples, FL
  • NPI 1710086293
  NPD (past)
• Bennett William McAllister, MD

  • Psychiatry Physician
  • Port Charlotte, FL
  • NPI 1275704157
  NPD (past)
• Judith A Tiberia, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Port Charlotte, FL
  • NPI 1811982473
  NPD (past)
• Lee Christenson, LMSW

  • Clinical Social Worker
  • Springdale, AR
  • NPI 1144592627
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1821213323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 510298",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339510298",
            "telephone_number": "041-764-6300",
            "fax_number": "941-764-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3466 DEPEW AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339527015",
            "telephone_number": "941-764-6300",
            "fax_number": "941-764-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANUEL GALLEGO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "GALLEGO",
        "authorized_official_first_name": "LYNNE",
        "authorized_official_middle_name": "PARKER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "941-764-6300",
        "authorized_official_name_prefix": "Prof.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "MH0004146",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME0076119",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karan Malani, DPM
• Adam Malick, DC
• Mamoon Jarrah MD PA (M. Jarrah MD PA)
• Andrea Mann
• Kimberly Grant Mansell, DO
• Maps Port Charlotte
• Marathon Health LLC
• Micah Owen Marazon, D.P.T.
• Marc a. Melser, MD, PL
• Glenn J Marcus, D.O.

• Counseling Psychologist in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Counseling Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.