Healthcare Provider Details

I. General information

NPI: 1992633473
Provider Name (Legal Business Name): SOFIA M VALIENTE-SUAREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PASEO DR. JOSE CELSO BARBOSA DR. GUILLERMO ARBONA BUILDING AEGD CLINIC
SAN JUAN PR
00921
US

IV. Provider business mailing address

93 CALLE ROMERILLO
SAN JUAN PR
00927-6624
US

V. Phone/Fax

Practice location:
  • Phone: 787-758-2525
  • 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 Number
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: