Healthcare Provider Details

I. General information

NPI: 1275760217
Provider Name (Legal Business Name): VALLE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2009
Last Update Date: 06/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 NANA AVE
ORLANDO FL
32809-5913
US

IV. Provider business mailing address

1013 CRYSTAL BAY LN
ORLANDO FL
32828-6636
US

V. Phone/Fax

Practice location:
  • Phone: 407-854-4018
  • Fax:
Mailing address:
  • Phone: 321-303-7702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License NumberAL 11561
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberAL 11561
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License NumberAL 11561
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberAL 11561
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberAL11561
License Number StateFL

VIII. Authorized Official

Name: MR. ALEX VALLE SR.
Title or Position: PRESIDENT
Credential:
Phone: 321-303-7702