Provider Demographics
NPI:1033186481
Name:VALLE, LUIS A (MD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:A
Last Name:VALLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 3 BOX 35303
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603-9465
Mailing Address - Country:US
Mailing Address - Phone:787-477-0608
Mailing Address - Fax:
Practice Address - Street 1:HC 3 BOX 35303
Practice Address - Street 2:
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603-9465
Practice Address - Country:US
Practice Address - Phone:787-477-0608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16009207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR4651546OtherFAMILY CARE
PR16009OtherBELLA VISTA
PR101035OtherCRUZ AZUL
PR2011368OtherPREFERRED HEALTH
PR3940OtherPREFERRED MED CHOICE
PRA433OtherFIRST MEDICAL
PR23314VAOtherTRIPLE SSS
PR4651546OtherFAMILY CARE