Healthcare Provider Details

I. General information

NPI: 1154103745
Provider Name (Legal Business Name): VALERIE MARTINEZ GUZMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S SEMORAN BLVD STE A
ORLANDO FL
32807-1424
US

IV. Provider business mailing address

744 NEUSE AVE
ORLANDO FL
32804-1732
US

V. Phone/Fax

Practice location:
  • Phone: 407-704-7811
  • Fax:
Mailing address:
  • Phone: 407-844-1843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: