MEDICARE: DR. PEDRO F. MATIAS VALLADARES M.D.

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	208D00000X	General Practice Physician	9774	PR

General Provider Information

NPI Number	:	1598710998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PEDRO F. MATIAS VALLADARES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1164
Second Line	:
City	:	GURABO
State	:	PR
Zip	:	00778-1164
Country	:	US
Telephone Number	:	787-258-6936
Fax Number	:

Provider Business Practice Location Address
First Line	:	EDIFICIO GALERIA MEDICA
Second Line	:	64 AVE SANTA CRUZ SUITE 106
City	:	BAYAMON
State	:	PR
Zip	:	00961-7003
Country	:	US
Telephone Number	:	787-785-6506
Fax Number	:

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

Provider Enumeration Date	:	05/23/2006
Last Update Date	:	09/26/2025

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