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General NPI Number Information
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NPI Number | 1396454534
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Entity Type | Individual
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Provider Name | HILDA ROMAN VALLE
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Gender | Female
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Dates
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Enumeration Date | 11/16/2022
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Last Update Date | 11/16/2022
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Provider Practice Location Address
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Address Line | CARRETERA 2 KM 133.5 BO GUANABANO
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City | AGUADA
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State | PR
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Zip | 00602
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Country | US
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Telephone | 939-358-4259
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Fax |
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Provider Business Mailing Address
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Address Line | HC 61 BOX 35318
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City | AGUADA
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State | PR
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Zip | 00602-9409
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Country | US
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Telephone | 939-358-4259
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 000621
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License Number State | PR
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