Provider Demographics
NPI:1053464164
Name:GALVEZ, ADOLFO SALVADOR (MD)
Entity Type:Individual
Prefix:DR
First Name:ADOLFO
Middle Name:SALVADOR
Last Name:GALVEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2370
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33509-2370
Mailing Address - Country:US
Mailing Address - Phone:813-684-6771
Mailing Address - Fax:
Practice Address - Street 1:1002 JOHN MOORE RD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-6302
Practice Address - Country:US
Practice Address - Phone:813-684-6771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME29615207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL79584Medicare ID - Type Unspecified
FLD27257Medicare UPIN