MEDICARE: VALLE CORP

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
1	3104A0625X	Assisted Living Facility (Mental Illness)	AL 11561	FL
2	314000000X	Skilled Nursing Facility	AL 11561	FL
3	315D00000X	Inpatient Hospice	AL 11561	FL
4	347C00000X	Private Vehicle
5	385H00000X	Respite Care	AL 11561	FL
6	310400000X	Assisted Living Facility	AL11561	FL

General Provider Information

NPI Number	:	1275760217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLE CORP

Provider Business Mailing Address
First Line	:	1013 CRYSTAL BAY LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-6636
Country	:	US
Telephone Number	:	321-303-7702
Fax Number	:

Provider Business Practice Location Address
First Line	:	807 NANA AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32809-5913
Country	:	US
Telephone Number	:	407-854-4018
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ALEX VALLE SR.
Credential	:
Telephone Number	:	321-303-7702

Provider Enumeration Date	:	06/17/2009
Last Update Date	:	06/17/2009

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Directions to “VALLE CORP ” Practice Location

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