Healthcare Provider Details

I. General information

NPI: 1710689351
Provider Name (Legal Business Name): VICTORIA LAURANN VALDEZ RN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 09/17/2023
Certification Date: 09/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 CENTERVILLE RD STE 202
TALLAHASSEE FL
32308-4638
US

IV. Provider business mailing address

1401 CENTERVILLE RD STE 202
TALLAHASSEE FL
32308-4638
US

V. Phone/Fax

Practice location:
  • Phone: 850-877-7241
  • Fax: 850-877-1338
Mailing address:
  • Phone: 850-877-7241
  • Fax: 850-877-1338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number33437
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberAPRN11028264
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: