Healthcare Provider Details

I. General information

NPI: 1609206002
Provider Name (Legal Business Name): VALERIE POLIDOR LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2013
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17051 NE 23RD AVE APT 2K
N MIAMI BEACH FL
33160-3744
US

IV. Provider business mailing address

17051 NE 23RD AVE APT 2K
N MIAMI BEACH FL
33160-3744
US

V. Phone/Fax

Practice location:
  • Phone: 917-284-4217
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3808259
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number940023
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11044872
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9510449
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: