Provider Demographics
NPI:1235518564
Name:GALLOWAY ORTHOPEDICS LLC
Entity type:Organization
Organization Name:GALLOWAY ORTHOPEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:GALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-284-4591
Mailing Address - Street 1:3953 TAMPA RD UNIT 101
Mailing Address - Street 2:
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3233
Mailing Address - Country:US
Mailing Address - Phone:727-464-2867
Mailing Address - Fax:727-464-2663
Practice Address - Street 1:3953 TAMPA RD UNIT 101
Practice Address - Street 2:
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677-3233
Practice Address - Country:US
Practice Address - Phone:727-464-2867
Practice Address - Fax:727-464-2663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-19
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty