Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | ME92818 | FL |
NPI | 1164419875 |
---|---|
Provider Name | Marlene Valentin |
First Address | Tampa, FL 33614-1852 |
Second Address | Tampa, FL 33614-1852 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2005 |
Last Update Date | 27/01/2010 |