MEDICARE: VERNON A VALENTINO MD

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	207RC0000X	Cardiovascular Disease Physician	18323	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	272685	OTHER	LA	MC GRP PTAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891787784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VERNON A VALENTINO MD

Provider Business Mailing Address
First Line	:	PO BOX 80354
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70598-0354
Country	:	US
Telephone Number	:	337-534-4143
Fax Number	:	337-534-4082

Provider Business Practice Location Address
First Line	:	5000 AMBASSADOR CAFFERY PKWY
Second Line	:	BUILDING 1, SUITE 100
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-6984
Country	:	US
Telephone Number	:	337-534-4143
Fax Number	:	337-534-4082

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

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	08/17/2015

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Directions to “ VERNON A VALENTINO MD” Practice Location

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