Healthcare Provider Details

I. General information

NPI: 1891354379
Provider Name (Legal Business Name): FRANKLIN ANTONIO VALDERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2019
Last Update Date: 05/14/2025
Certification Date: 05/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 DOWNWOOD CIR NW STE 640-4
ATLANTA GA
30327-1610
US

IV. Provider business mailing address

MCHE-ZSS-G 3551 ROGER BROOKE DRIVE
JBSA FSH TX
78234
US

V. Phone/Fax

Practice location:
  • Phone: 404-951-5032
  • Fax:
Mailing address:
  • Phone: 210-916-0439
  • Fax: 210-916-6658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101271431
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: