MEDICARE: YAMILY VALDES M.D.

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	208000000X	Pediatrics Physician	ME9958	FL
2	208M00000X	Hospitalist Physician	ME99587	FL
3	208000000X	Pediatrics Physician	ME99587	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME99587	OTHER	FL	LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841470853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YAMILY VALDES M.D.

Provider Business Mailing Address
First Line	:	1033 DR MARTIN LUTHER KING JR ST N STE 108
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-1547
Country	:	US
Telephone Number	:	727-456-4250
Fax Number	:	727-346-1044

Provider Business Practice Location Address
First Line	:	1600 SW ARCHER RD
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32610-3753
Country	:	US
Telephone Number	:	352-627-9350
Fax Number	:

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

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	11/24/2020

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