Healthcare Provider Details

I. General information

NPI: 1124970991
Provider Name (Legal Business Name): MS. VALERIA ISABEL FALCON CARMONA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 E 25TH ST
HIALEAH FL
33013-3817
US

IV. Provider business mailing address

11074 NW 86TH TER
DORAL FL
33178-2315
US

V. Phone/Fax

Practice location:
  • Phone: 786-329-1471
  • Fax:
Mailing address:
  • Phone: 786-329-1471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberDRPM3008
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3008
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: