Healthcare Provider Details

I. General information

NPI: 1518923812
Provider Name (Legal Business Name): FARRAR VALINE DURO A.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3408 W 84TH ST STE 309
HIALEAH GARDENS FL
33018-4944
US

IV. Provider business mailing address

3408 W 84TH ST STE 309
HIALEAH GARDENS FL
33018-4944
US

V. Phone/Fax

Practice location:
  • Phone: 954-765-6505
  • Fax:
Mailing address:
  • Phone: 954-765-6505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP1483
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: