1679570683 NPI number — DAVID L GALBUT MD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679570683 NPI number — DAVID L GALBUT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GALBUT
Provider First Name:
DAVID
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1679570683
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/15/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 577
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CIRCLE PINES
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55014-0577
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-268-8229
Provider Business Mailing Address Fax Number:
786-268-4561

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4770 BISCAYNE BLVD
Provider Second Line Business Practice Location Address:
SUITE 880
Provider Business Practice Location Address City Name:
MIAMI
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33137-3202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-268-8229
Provider Business Practice Location Address Fax Number:
786-268-4561
Provider Enumeration Date:
07/05/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208G00000X , with the licence number:  ME28970 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 95675Z . This is a "PHYSICIANS HEALTH CARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 95675C . This is a "BEECHSTREET" identifier . This identifiers is of the category "OTHER".
  • Identifier: M289701 . This is a "PREFERRED MEDICAL PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 180 . This is a "TOTAL HEALTH CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 780001501 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 040530200 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2092136 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 234411 . This is a "AVMED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 95675Z . This is a "HEALTH EASE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 05585 . This is a "NEIGHBORHOOD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 22431 . This is a "WELLCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 05606 . This is a "UNIVERSAL HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1001693 . This is a "CARE PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 200841 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: D64817 . This is a "VISTA" identifier . This identifiers is of the category "OTHER".
  • Identifier: ME28970 . This is a "STATE MEDICAL LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 95675 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 040530200 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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