Provider Demographics
NPI:1992747174
Name:VERA-GALVAN, ELISEL (MD)
Entity type:Individual
Prefix:
First Name:ELISEL
Middle Name:
Last Name:VERA-GALVAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6101 BLUE LAGOON DR STE 400
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-2051
Mailing Address - Country:US
Mailing Address - Phone:727-375-1953
Mailing Address - Fax:727-375-1372
Practice Address - Street 1:8813 RIVER CROSSING BLVD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-5132
Practice Address - Country:US
Practice Address - Phone:727-375-1953
Practice Address - Fax:727-375-1372
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME95995207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine