Healthcare Provider Details

I. General information

NPI: 1750849808
Provider Name (Legal Business Name): VALENTINA ARISTIZABAL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2019
Last Update Date: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2990 CORAL WAY
MIAMI FL
33145-3206
US

IV. Provider business mailing address

4725 NW 85TH AVE UNIT 11
MIAMI FL
33166-5965
US

V. Phone/Fax

Practice location:
  • Phone: 305-529-9295
  • Fax:
Mailing address:
  • Phone: 305-542-6492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN24737
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: