Healthcare Provider Details

I. General information

NPI: 1760856108
Provider Name (Legal Business Name): VALERIE HURTADO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2015
Last Update Date: 11/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11755 SW 90TH ST 210
MIAMI FL
33186-2178
US

IV. Provider business mailing address

11755 SW 90TH ST 210
MIAMI FL
33186
US

V. Phone/Fax

Practice location:
  • Phone: 305-846-9807
  • Fax: 305-846-9711
Mailing address:
  • Phone: 305-846-9807
  • Fax: 305-846-9711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: