Provider Demographics
NPI:1396392767
Name:GALVEZ RICARDO, YURELSY (MD)
Entity type:Individual
Prefix:
First Name:YURELSY
Middle Name:
Last Name:GALVEZ RICARDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 MIDDLE BRANCH WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-6201
Mailing Address - Country:US
Mailing Address - Phone:305-773-3129
Mailing Address - Fax:
Practice Address - Street 1:725 MIDDLE BRANCH WAY
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32259-6201
Practice Address - Country:US
Practice Address - Phone:305-773-3129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR21505208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice