Healthcare Provider Details

I. General information

NPI: 1174901839
Provider Name (Legal Business Name): DR EMERSON VALDEZ DPM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 05/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 NW 42ND AVE STE 315
MIAMI FL
33126-5688
US

IV. Provider business mailing address

351 NW 42ND AVE STE 315
MIAMI FL
33126-5688
US

V. Phone/Fax

Practice location:
  • Phone: 305-812-8001
  • Fax:
Mailing address:
  • Phone: 305-812-8001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberPO3673
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberPO3673
License Number StateFL

VIII. Authorized Official

Name: DR. EMERSON ADNER VALDEZ
Title or Position: OWNER PHYSICIAN
Credential: DPM
Phone: 561-315-7498