Healthcare Provider Details

I. General information

NPI: 1467616102
Provider Name (Legal Business Name): MARIA JOSE VALENCIA- SERAFINI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 10/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14027 5TH ST
DADE CITY FL
33525-4302
US

IV. Provider business mailing address

8108 N NEBRASKA AVE
TAMPA FL
33604-3103
US

V. Phone/Fax

Practice location:
  • Phone: 352-518-2000
  • Fax: 352-567-0218
Mailing address:
  • Phone: 813-636-2000
  • Fax: 813-876-0472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberOS 10996
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: