Healthcare Provider Details

I. General information

NPI: 1952258295
Provider Name (Legal Business Name): CRISTHIAN VALLADARES APRN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8849 NW 119TH ST UNIT 208
HIALEAH GARDENS FL
33018-7927
US

IV. Provider business mailing address

8849 NW 119TH ST UNIT 208
HIALEAH GARDENS FL
33018-7927
US

V. Phone/Fax

Practice location:
  • Phone: 786-683-8226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11042334
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: