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General NPI Number Information
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NPI Number | 1386257178
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Entity Type | Organization
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Legal Business Name | DR NELLY VALENCIA DDS PA
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 08/31/2020
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Provider Practice Location Address
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Address Line | 4011 W FLAGLER ST STE 201
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City | CORAL GABLES
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State | FL
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Zip | 33134-1643
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Country | US
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Telephone | 305-649-4242
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Fax | 305-508-6620
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Provider Business Mailing Address
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Address Line | 4011 W FLAGLER ST STE 201
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City | CORAL GABLES
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State | FL
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Zip | 33134-1643
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Country | US
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Telephone | 305-649-4242
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Fax | 305-508-6620
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. NELLY VALENCIA
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Credential | DDS, PA
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Telephone | 305-649-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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