MEDICARE: EDGARDO ARTURO VALDES SA-C

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	363A00000X	Physician Assistant	0592-P.A.	PR
2	363AS0400X	Surgical Physician Assistant	0592-P.A.	PR
3	246ZC0007X	Surgical Assistant	15-189	FL

General Provider Information

NPI Number	:	1316483332
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDGARDO ARTURO VALDES SA-C

Provider Business Mailing Address
First Line	:	10120 CARIBBEAN BLVD
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33189-1526
Country	:	US
Telephone Number	:	305-797-9658
Fax Number	:

Provider Business Practice Location Address
First Line	:	10120 CARIBBEAN BLVD
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33189-1526
Country	:	US
Telephone Number	:	305-797-9658
Fax Number	:

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

Provider Enumeration Date	:	01/13/2017
Last Update Date	:	12/08/2025

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