Healthcare Provider Details

I. General information

NPI: 1659616167
Provider Name (Legal Business Name): MISS DANNA ROCIO VALENTIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2012
Last Update Date: 12/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69020 CALLE ANA E MACHADO VALLE
ISABELA PR
00662
US

IV. Provider business mailing address

2401 CARR 494
ISABELA PR
00662-4326
US

V. Phone/Fax

Practice location:
  • Phone: 787-872-8172
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4659268
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: