Healthcare Provider Details

I. General information

NPI: 1306793351
Provider Name (Legal Business Name): GERTRUDIS M. VALDEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 06/14/2026
Certification Date: 06/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

551 HUFFSTETLER DR
EUSTIS FL
32726-8220
US

IV. Provider business mailing address

551 HUFFSTETLER DR
EUSTIS FL
32726-8220
US

V. Phone/Fax

Practice location:
  • Phone: 786-316-6345
  • Fax:
Mailing address:
  • Phone: 786-316-6345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: