Provider Demographics
NPI:1487607289
Name:GALVEZ, NICK JOSEPH (PT)
Entity type:Individual
Prefix:MR
First Name:NICK
Middle Name:JOSEPH
Last Name:GALVEZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:NICHOLAS
Other - Middle Name:
Other - Last Name:GALVEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:108 BERMUDA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33606-3324
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:108 BERMUDA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-3324
Practice Address - Country:US
Practice Address - Phone:813-839-6341
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT14159225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist