Healthcare Provider Details

I. General information

NPI: 1497267686
Provider Name (Legal Business Name): ANGEL L VALLADARES ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/29/2017
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6607 N DALE MABRY HWY
TAMPA FL
33614-3985
US

IV. Provider business mailing address

6607 N DALE MABRY HWY
TAMPA FL
33614-3985
US

V. Phone/Fax

Practice location:
  • Phone: 813-499-1500
  • Fax: 813-499-1499
Mailing address:
  • Phone: 813-499-1500
  • Fax: 813-499-1499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9341366
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: