Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 50101022350 | MI |
N | 111NI0900X | Internist | 50101022350 | MI |
Y | 207RA0201X | Internist - Allergy & Immunology | 34.014067 | OH |
NPI | 1346690518 |
---|---|
Provider Name | Reimus Valencia |
First Address | Mayfield Heights, OH 44124-4034 |
Second Address | Mayfield Heights, OH 44124-4034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2016 |
Last Update Date | 22/01/2021 |