MEDICARE: LUZ DELIA GALVEZ P.H.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	2402	PR

General Provider Information

NPI Number	:	1629385448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUZ DELIA GALVEZ P.H.

Provider Business Mailing Address
First Line	:	URB. SAN FERNANDO L39
Second Line	:
City	:	BAYAMON
State	:	PR
Zip	:	00957-0000
Country	:	US
Telephone Number	:	787-358-2514
Fax Number	:

Provider Business Practice Location Address
First Line	:	CALLE TENIENTE CESAR GONZALEZ
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00923-0000
Country	:	US
Telephone Number	:	787-758-8019
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2010
Last Update Date	:	09/01/2010

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