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General NPI Number Information
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NPI Number | 1265763510
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Entity Type | Organization
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Legal Business Name | JACQUELINE VALDES-RAFULS, M.D., P.A.
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Dates
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Enumeration Date | 01/27/2010
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Last Update Date | 02/12/2010
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Provider Practice Location Address
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Address Line | 8000 SW 117TH AVE SUITE #200
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City | MIAMI
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State | FL
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Zip | 33183-4803
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Country | US
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Telephone | 305-273-7950
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Fax | 305-273-7954
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Provider Business Mailing Address
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Address Line | 8000 SW 117TH AVE SUITE #200
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City | MIAMI
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State | FL
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Zip | 33183-4803
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Country | US
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Telephone | 305-273-7950
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Fax | 305-273-7954
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Authorized Official
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Title or Position | DOCTOR
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Name | MRS. JACQUELINE VALDES-RAFULS
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Credential | M.D.
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Telephone | 305-273-7950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PAX0000707
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | ARNP2528362
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME0062887
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License Number State | FL
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