Healthcare Provider Details

I. General information

NPI: 1235771288
Provider Name (Legal Business Name): JOSE GABRIEL VALDES DNP, APRN, PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10689 N KENDALL DR STE 211
MIAMI FL
33176-1594
US

IV. Provider business mailing address

10689 N KENDALL DR STE 211
MIAMI FL
33176-1594
US

V. Phone/Fax

Practice location:
  • Phone: 305-204-9499
  • Fax: 507-607-8720
Mailing address:
  • Phone: 305-204-9499
  • Fax: 507-607-8720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberRN9512079
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11015471
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: