Healthcare Provider Details

I. General information

NPI: 1396685269
Provider Name (Legal Business Name): PATRICIA GAVILAN VALMASEDA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1016 PEACHWOOD DR
BRANDON FL
33510-2575
US

IV. Provider business mailing address

1016 PEACHWOOD DR
BRANDON FL
33510-2575
US

V. Phone/Fax

Practice location:
  • Phone: 813-562-2998
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-26-522460
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: