Healthcare Provider Details

I. General information

NPI: 1295887289
Provider Name (Legal Business Name): ANGELINA VALLADARES BERNIER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANGELINA IMELDA VALLADARES MD

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD # 100296
GAINESVILLE FL
32610-4001
US

IV. Provider business mailing address

1600 SW ARCHER RD # 100296
GAINESVILLE FL
32610-3003
US

V. Phone/Fax

Practice location:
  • Phone: 352-294-5281
  • Fax: 352-627-4415
Mailing address:
  • Phone: 352-294-5281
  • Fax: 352-627-4415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME102519
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberME102519
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: