MEDICARE: VALERIA BELEM NIETO GONZALEZ APRN

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	363LF0000X	Family Nurse Practitioner	11030129	FL

General Provider Information

NPI Number	:	1992573992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERIA BELEM NIETO GONZALEZ APRN

Provider Business Mailing Address
First Line	:	1150 25TH ST SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32962-8035
Country	:	US
Telephone Number	:	772-708-7940
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 25TH ST SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32962-8035
Country	:	US
Telephone Number	:	772-708-7940
Fax Number	:

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

Provider Enumeration Date	:	12/19/2023
Last Update Date	:	02/11/2024

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