Provider Demographics
NPI:1487740221
Name:DELVALLE GALARZA, LUIS R (MD)
Entity type:Individual
Prefix:DR
First Name:LUIS
Middle Name:R
Last Name:DELVALLE GALARZA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:CALLE MUNOZ RIVERA
Mailing Address - Street 2:NUM 5 NORTE
Mailing Address - City:SAN LORENZO
Mailing Address - State:PR
Mailing Address - Zip Code:00754-3919
Mailing Address - Country:US
Mailing Address - Phone:787-736-4071
Mailing Address - Fax:787-736-4071
Practice Address - Street 1:CALLE MUNOZ RIVERA
Practice Address - Street 2:NUM 5 NORTE
Practice Address - City:SAN LORENZO
Practice Address - State:PR
Practice Address - Zip Code:00754-3919
Practice Address - Country:US
Practice Address - Phone:787-736-4071
Practice Address - Fax:787-736-4071
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2010-04-29
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Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR4338207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC79485Medicare UPIN
PR0025812Medicare ID - Type Unspecified