MEDICARE: DR. RUBEN MARCOS VALDES DO

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	207Q00000X	Family Medicine Physician	0S3207	FL
2	207Q00000X	Family Medicine Physician	OS0003207	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110013728	OTHER	FL	RR MEDICARE
10	592746543	OTHER	FL	WELLCARE MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	33864	OTHER	FL	BLUE SHIELD
3	6525156	OTHER	FL	CIGNA
4	069086400	OTHER	FL	WORKMAN'S COMP
5	4644617	OTHER	FL	AETNA
6	232964	OTHER	FL	WELLCARE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	209545	OTHER	FL	AVMED
9	9326165	OTHER	FL	AETNA GROUP #

General Provider Information

NPI Number	:	1790882801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUBEN MARCOS VALDES DO

Provider Business Mailing Address
First Line	:	7519 PAULA DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-4113
Country	:	US
Telephone Number	:	813-884-1478
Fax Number	:	813-884-1798

Provider Business Practice Location Address
First Line	:	7519 PAULA DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-4113
Country	:	US
Telephone Number	:	813-884-1478
Fax Number	:	813-884-1798

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	03/23/2017

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