MEDICARE: ATHENA L VALENCIA MD PA

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	207R00000X	Internal Medicine Physician	ME66946	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME66946	OTHER	FL	FLORIDA MEDICAL LICENSE

General Provider Information

NPI Number	:	1770750705
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATHENA L VALENCIA MD PA

Provider Business Mailing Address
First Line	:	2726 WINDGUARD CIR
Second Line	:	STE 101
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-7361
Country	:	US
Telephone Number	:	813-973-8167
Fax Number	:	813-991-7654

Provider Business Practice Location Address
First Line	:	8702 BAY LAUREL CT
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-2280
Country	:	US
Telephone Number	:	813-973-8167
Fax Number	:	813-991-7654

Authorized Official
Title or Position	:	MD/OWNER
Name	:	ATHENA L VALENCIA
Credential	:	MD
Telephone Number	:	813-973-8167

Provider Enumeration Date	:	05/09/2008
Last Update Date	:	04/17/2026

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