MEDICARE: HANSEL VALDES BA

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	363LF0000X	Family Nurse Practitioner	11022289	FL
2	363L00000X	Nurse Practitioner	APRN11022289	FL
3	208100000X	Physical Medicine & Rehabilitation Physician	APRN11022289	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497782510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANSEL VALDES BA

Provider Business Mailing Address
First Line	:	1776 WOODSTEAD CT STE 208
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77380-1480
Country	:	US
Telephone Number	:	281-724-3050
Fax Number	:

Provider Business Practice Location Address
First Line	:	16650 W DIXIE HWY
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33160-3713
Country	:	US
Telephone Number	:	305-945-7447
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2006
Last Update Date	:	12/01/2025

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