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General NPI Number Information
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NPI Number | 1427445972
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Entity Type | Individual
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Provider Name | MARCO VALDES
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Gender | Male
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 04/22/2015
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Provider Practice Location Address
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Address Line | 2720 SW 97TH AVE # 208
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City | MIAMI
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State | FL
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Zip | 33165-2677
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Country | US
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Telephone | 305-549-8085
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Fax | 305-549-8790
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Provider Business Mailing Address
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Address Line | 2720 SW 97TH AVE # 208
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City | MIAMI
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State | FL
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Zip | 33165-2677
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Country | US
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Telephone | 305-549-8085
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Fax | 305-549-8790
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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 | 247100000X
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Taxonomy Name | Radiologic Technologist
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License Number | CRT67465
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License Number State | FL
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