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General NPI Number Information
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NPI Number | 1063462844
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Entity Type | Individual
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Provider Name | MARIA LUZ BERNABE VALENCIA RPT
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Gender | Female
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 15127 JOG RD SUITE 106
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City | DELRAY BEACH
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State | FL
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Zip | 33446-1251
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Country | US
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Telephone | 561-495-6300
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Fax | 561-495-8877
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Provider Business Mailing Address
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Address Line | 951 BROKEN SOUND PKWY NW SUITE 225
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City | BOCA RATON
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State | FL
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Zip | 33487-3507
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Country | US
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Telephone | 561-241-9300
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Fax | 561-658-3992
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PT9466
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License Number State | FL
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