Basic Information
| Provider Information | |||||||||
| NPI: | 1609830371 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GALVEZ-JIMENEZ | ||||||||
| FirstName: | NESTOR | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2950 CLEVELAND CLINIC BLVD | ||||||||
| Address2: | |||||||||
| City: | WESTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333313609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546595000 | ||||||||
| FaxNumber: | 9546595358 | ||||||||
| Practice Location | |||||||||
| Address1: | 2950 CLEVELAND CLINIC BLVD | ||||||||
| Address2: | |||||||||
| City: | WESTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333313609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546595000 | ||||||||
| FaxNumber: | 9546595358 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 10/27/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | ME0070836 | FL | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology |
ID Information
| ID | Type | State | Issuer | Description | 250340900 | 05 | FL | MEDICAID |