Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | APRN9199204 | FL |
N | 363LP0200X | Nurse Practitioner - Pediatrics | ARNP9199204 | FL |
NPI | 1013252410 |
---|---|
Provider Name | Mrs. Jessica Marie Valente |
First Address | Apopka, FL 32703-6619 |
Second Address | Winter Haven, FL 33881 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2012 |
Last Update Date | 21/08/2019 |