Provider Demographics
NPI:1982448270
Name:CARMONA GALVEZ, REINALDO (NP-C)
Entity type:Individual
Prefix:
First Name:REINALDO
Middle Name:
Last Name:CARMONA GALVEZ
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7746 62ND ST N APT B
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3243
Mailing Address - Country:US
Mailing Address - Phone:727-348-9091
Mailing Address - Fax:
Practice Address - Street 1:7746 62ND ST N APT B
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3243
Practice Address - Country:US
Practice Address - Phone:727-348-9091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11033555363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily