Provider Demographics
NPI:1003113424
Name:POIRIER, VALERIE LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:LYNN
Last Name:POIRIER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 W COLONIAL DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-7101
Mailing Address - Country:US
Mailing Address - Phone:407-423-1768
Mailing Address - Fax:407-423-0143
Practice Address - Street 1:1512 W COLONIAL DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-7101
Practice Address - Country:US
Practice Address - Phone:407-423-1768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-21
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPA1768363AM0700X
CA53608363AM0700X
FLPA9105909363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical