Healthcare Provider Details

I. General information

NPI: 1255596292
Provider Name (Legal Business Name): MARIA T VALENTIN VALENTIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE DEL CARMEN #55
FAJARDO PR
00738
US

IV. Provider business mailing address

HC 61 BOX 4756
TRUJILLO ALTO PR
00976-9724
US

V. Phone/Fax

Practice location:
  • Phone: 787-860-3558
  • Fax: 787-860-7066
Mailing address:
  • Phone: 787-860-3558
  • Fax: 787-860-7066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number016356
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: