Provider Demographics
NPI:1881685931
Name:GALVEZ, ROGER DAVID (MD)
Entity Type:Individual
Prefix:MR
First Name:ROGER
Middle Name:DAVID
Last Name:GALVEZ
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9193 SUNSET DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3456
Mailing Address - Country:US
Mailing Address - Phone:305-595-5558
Mailing Address - Fax:305-595-3112
Practice Address - Street 1:9193 SUNSET DR
Practice Address - Street 2:SUITE 210
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3456
Practice Address - Country:US
Practice Address - Phone:305-595-5558
Practice Address - Fax:305-595-3112
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2010-02-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME57126207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12634OtherBCBS
FL006180OtherNHP
FL056543100Medicaid
FL056543100Medicaid
F07357Medicare UPIN