Provider Demographics
NPI:1588248959
Name:GALVEZ, JESUS MANUEL (PA)
Entity type:Individual
Prefix:DR
First Name:JESUS
Middle Name:MANUEL
Last Name:GALVEZ
Suffix:
Gender:M
Credentials:PA
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 7602
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7602
Mailing Address - Country:US
Mailing Address - Phone:787-457-0974
Mailing Address - Fax:
Practice Address - Street 1:240 VIA CAMPINA
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00727-3098
Practice Address - Country:US
Practice Address - Phone:787-635-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR391-PA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant