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General NPI Number Information
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NPI Number | 1801853056
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Entity Type | Individual
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Provider Name | MARIA TERESA VALDES M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 774 SR 13 NORTH SUITE 6
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City | ST JOHNS
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State | FL
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Zip | 32259-3815
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Country | US
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Telephone | 904-786-9600
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Fax | 904-786-6036
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Provider Business Mailing Address
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Address Line | 774 SR 13 NORTH SUITE 6
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City | ST JOHNS
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State | FL
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Zip | 32259-3815
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Country | US
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Telephone | 904-786-9600
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Fax | 904-786-6036
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME53283
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License Number State | FL
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