Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 25MA03725700 | NJ |
NPI | 1033212113 |
---|---|
Provider Name | Dr. Sandra Valdez |
First Address | Wesley Chapel, FL 33544-1544 |
Second Address | Wesley Chapel, FL 33544-1544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1571206 | (05) | GA |
B17204 | (02) | NJ |