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General NPI Number Information
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NPI Number | 1477144707
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Entity Type | Individual
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Provider Name | VICTORIA VALIANTE LMT
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Gender | Female
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Dates
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Enumeration Date | 01/29/2021
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 2632 NW 43RD ST STE 3124
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City | GAINESVILLE
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State | FL
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Zip | 32606-7546
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Country | US
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Telephone | 352-448-9887
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Fax |
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Provider Business Mailing Address
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Address Line | 6600 SW 13TH ST APT B
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City | GAINESVILLE
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State | FL
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Zip | 32608-5417
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Country | US
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Telephone | 904-631-2508
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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 | MA95324
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License Number State | FL
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