NPIMap

Organization Active NPI

Domingo E Galliano Jr PA

  • Colon & Rectal Surgery Physician
  • Port Charlotte, FL
National Provider Identifier
1902060601
Registry record updated Aug 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
ME54294 Issued in FL
Legal business name
DOMINGO E GALLIANO JR PA
Practice address
18308 Murdock Circle 108
Domingo E Galliano Jr MD PA
Port Charlotte, FL 33948
Phone
(941) 625-1033
Fax
(941) 625-1792
NPI assigned
Jul 11, 2008
Last updated
Aug 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2013

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

Authorized official

Name
Dr. Domingo E Galliano, MDNPI 1689784076
Title
Owner
Phone
(941) 625-1033

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X ME54294 FL
Surgical Critical Care PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0102X ME54294 FL
Colon & Rectal Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208C00000X ME54294 FL Primary

Addresses

Primary practice location

18308 Murdock Circle 108
Domingo E Galliano Jr MD PA
Port Charlotte, FL 33948

Mailing address

18308 Murdock Circle 108
Domingo E Galliano Jr MD PA
Port Charlotte, FL 33948
Phone (941) 625-1033

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080827000311 FL Part B Supplier - Clinic/Group Practice 9638245640 Receives reassigned benefits from 6 practitioners
Practice locations: Cape Coral, FL; Englewood, FL; Port Charlotte, FL

National Provider Directory

National Provider Directory

Locations

2521 Del Prado Blvd N
Cape Coral, FL 33909
Phone (239) 242-1357

3937 S Access Rd
Unit B
Englewood, FL 34224
Phone (586) 215-9493

18308 Murdock Cir
#108109
Port Charlotte, FL 33948
Phone (941) 625-3411

18308 Murdock Cir
Unit 108
Pt Charlotte, FL 33948
Phone (941) 625-1033

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17708/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1215734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377561600000",
    "number": "1902060601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18308 MURDOCK CIRCLE 108",
            "address_2": "DOMINGO E GALLIANO JR MD PA",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33948",
            "telephone_number": "941-625-1033",
            "fax_number": "941-625-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18308 MURDOCK CIRCLE 108",
            "address_2": "DOMINGO E GALLIANO JR MD PA",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "33948",
            "telephone_number": "941-625-1033",
            "fax_number": "941-625-1792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINGO E GALLIANO JR PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-11",
        "last_updated": "2013-08-27",
        "status": "A",
        "authorized_official_last_name": "GALLIANO",
        "authorized_official_first_name": "DOMINGO",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-625-1033",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME54294",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME54294",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": "FL",
            "license": "ME54294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.