Healthcare Provider Details

I. General information

NPI: 1649598418
Provider Name (Legal Business Name): VALENCIA MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2010
Last Update Date: 11/04/2022
Certification Date: 11/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9804 SW 40TH ST
MIAMI FL
33165-3912
US

IV. Provider business mailing address

9804 SW 40TH ST
MIAMI FL
33165-3912
US

V. Phone/Fax

Practice location:
  • Phone: 305-222-9154
  • Fax: 305-222-9155
Mailing address:
  • Phone: 305-222-9154
  • Fax: 305-222-9155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberME98844
License Number StateFL

VIII. Authorized Official

Name: MRS. JUDITH VALENCIA
Title or Position: PRESIDENT
Credential:
Phone: 305-222-9154