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General NPI Number Information
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NPI Number | 1497486484
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Entity Type | Individual
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Provider Name | ROGELIO F DEL VALLE VALLADARES MD
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Gender | Male
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Dates
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Enumeration Date | 06/21/2022
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 5307 MAIN ST
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City | NEW PORT RICHEY
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State | FL
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Zip | 34652-2536
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Country | US
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Telephone | 727-900-7788
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Fax |
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Provider Business Mailing Address
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Address Line | 9804 BENNINGTON DR
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City | TAMPA
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State | FL
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Zip | 33626-2442
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Country | US
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Telephone | 786-362-9283
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 022696
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ACN1514
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License Number State | FL
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