MEDICARE: DR. LEONARD J VALDES D.C.

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	111N00000X	Chiropractor	CH8730	FL

General Provider Information

NPI Number	:	1699726539
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEONARD J VALDES D.C.

Provider Business Mailing Address
First Line	:	315 NW 109TH AVE
Second Line	:	#208
City	:	MIAMI
State	:	FL
Zip	:	33172-5250
Country	:	US
Telephone Number	:	305-283-8965
Fax Number	:	305-441-0415

Provider Business Practice Location Address
First Line	:	3271 NW 7TH ST
Second Line	:	#202
City	:	MIAMI
State	:	FL
Zip	:	33125-4141
Country	:	US
Telephone Number	:	305-644-7980
Fax Number	:	305-644-7982

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

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	07/08/2007

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