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General NPI Number Information
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NPI Number | 1154502664
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Entity Type | Organization
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Legal Business Name | VALLEY SURIGAL
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 21 MEDICAL PARK
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City | VALLEY
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State | AL
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Zip | 36854
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Country | US
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Telephone | 334-756-2146
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Fax |
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Provider Business Mailing Address
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Address Line | 21 MEDICAL PARK
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City | VALLEY
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State | AL
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Zip | 36854-3665
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Country | US
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Telephone | 334-756-2146
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FERNANDO SANCHEZ
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Credential | MD
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Telephone | 334-756-2146
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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 | 000891
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License Number State | AL
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