Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 11452 | FL |
N | 111NR0400X | Rehabilitation Chiropractor | 453 | PR |
NPI | 1609014018 |
---|---|
Provider Name | Dr. Ruben Valdes |
First Address | Doral, FL 33166-5457 |
Second Address | Doral, FL 33166-5457 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2009 |
Last Update Date | 04/06/2015 |