Healthcare Provider Details

I. General information

NPI: 1851553879
Provider Name (Legal Business Name): DOUGLAS VALENTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1888 KALAKAUA AVE APT 2904
HONOLULU HI
96815-1535
US

IV. Provider business mailing address

9110 COLLEGE POINTE CT
FORT MYERS FL
33919-3244
US

V. Phone/Fax

Practice location:
  • Phone: 808-366-1087
  • Fax:
Mailing address:
  • Phone: 239-208-2212
  • Fax: 239-208-3994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberC161297
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD176943
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4301116530
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License NumberMD476853
License Number StatePA
# 5
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD60694768
License Number StateWA
# 6
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number29146
License Number StateNE
# 7
Primary TaxonomyY
Taxonomy Code2084V0102X
TaxonomyVascular Neurology Physician
License Number15231
License Number StateHI
# 8
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number298923
License Number StateNY
# 9
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number58465
License Number StateTN
# 10
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberE-15186
License Number StateAR
# 11
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number35.135089
License Number StateOH
# 12
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number27787
License Number StateMS
# 13
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number81707
License Number StateSC
# 14
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMC-0054
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: