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General NPI Number Information
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NPI Number | 1609206002
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Entity Type | Individual
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Provider Name | VALERIE POLIDOR LPN
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Gender | Female
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Dates
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Enumeration Date | 11/21/2013
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Last Update Date | 12/03/2016
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Provider Practice Location Address
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Address Line | 17051 NE 23RD AVE APT 2K
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City | N MIAMI BEACH
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State | FL
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Zip | 33160-3744
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Country | US
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Telephone | 917-284-4217
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Fax |
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Provider Business Mailing Address
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Address Line | 17051 NE 23RD AVE APT 2K
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City | N MIAMI BEACH
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State | FL
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Zip | 33160-3744
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Country | US
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Telephone |
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 316932
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN5224751
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License Number State | FL
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