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NPI Code Detail

MEDICARE: REBECCA VALDEZ LLC

MEDICARE: REBECCA VALDEZ LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1144050824
Entity Type Code : Organization
Provider Name (Legal Business Name) : REBECCA VALDEZ LLC
Provider Business Mailing Address
First Line : 2638 S KEELING RD
Second Line :
City : CASA GRANDE
State : AZ
Zip : 85193-8606
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2562 QUEENSTON RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-4352
Country : US
Telephone Number : 646-740-1928
Fax Number :
Authorized Official
Title or Position : REGISTERED DIETITIAN
Name : REBECCA VALDEZ
Credential : RD
Telephone Number : 646-740-1928
Provider Enumeration Date : 08/06/2024
Last Update Date : 08/06/2024

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