Individual
KENNETH J GALANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13710 METROPOLIS AVE, SUITE 110, FORT MYERS, FL 33912-7144
(239) 225-0129
(239) 225-0575
Mailing address
PO BOX 07382, FORT MYERS, FL 33919-0382
(239) 225-0129
(239) 225-0575
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
ME0075093
FL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME0075093
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1631062002
CIGNA HMO
FL
01
—
1823430
UHC
FL
01
—
2025126
AETNA HMO
FL
05
—
255349000
—
FL
01
—
44525
BCBS
FL
01
—
5705641
AETNA PPO
FL
01
—
592207264
CIGNA PPO
FL
01
—
592207264E
HUMANA
FL
Enumeration date
08/05/2006
Last updated
11/12/2011
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