Provider Demographics
NPI:1740980051
Name:GALVEZ HERNANDEZ, JAVIER ALBERTO
Entity type:Individual
Prefix:
First Name:JAVIER
Middle Name:ALBERTO
Last Name:GALVEZ HERNANDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10307 NW 9TH STREET CIR APT 201
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-3287
Mailing Address - Country:US
Mailing Address - Phone:786-253-7463
Mailing Address - Fax:
Practice Address - Street 1:10307 NW 9TH STREET CIR APT 201
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-3287
Practice Address - Country:US
Practice Address - Phone:786-253-7463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-255847106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician