Healthcare Provider Details

I. General information

NPI: 1255988275
Provider Name (Legal Business Name): JULIO EDUARDO VALDES JR. PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2019
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8850 N US HIGHWAY 1
SEBASTIAN FL
32958-7553
US

IV. Provider business mailing address

PO BOX 297414
KERRVILLE TX
78029
US

V. Phone/Fax

Practice location:
  • Phone: 305-807-8985
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA22405
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: