Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | MC0060196 | FL |
NPI | 1275600314 |
---|---|
Provider Name | Richard Valdesuso |
First Address | Sarasota, FL 34239-2943 |
Second Address | Sarasota, FL 34239-2943 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 22/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1609826734 | GROUP NPI (01) | FL |
624522 | AETNA (01) | |
E93265 | (02) |