MEDICARE: RICHARD JAMES VALENTINE PARAMEDIC

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	146L00000X	Paramedic	528229	FL

General Provider Information

NPI Number	:	1376154047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD JAMES VALENTINE PARAMEDIC

Provider Business Mailing Address
First Line	:	2712 MIRACLE PKWY
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-3801
Country	:	US
Telephone Number	:	239-896-8592
Fax Number	:

Provider Business Practice Location Address
First Line	:	2712 MIRACLE PKWY
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33914-3801
Country	:	US
Telephone Number	:	239-896-8592
Fax Number	:

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

Provider Enumeration Date	:	08/14/2020
Last Update Date	:	08/14/2020

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