Provider Demographics
NPI:1104137207
Name:GALLO-THYS, TERESA (DO)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:GALLO-THYS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:
Other - Last Name:GALLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:6615 W BOYNTON BEACH BLVD STE 412
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3526
Mailing Address - Country:US
Mailing Address - Phone:561-882-4541
Mailing Address - Fax:561-650-6093
Practice Address - Street 1:2300 S CONGRESS AVE STE 105
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-7400
Practice Address - Country:US
Practice Address - Phone:561-203-5282
Practice Address - Fax:740-212-8513
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7902208M00000X
FLOS13449208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist