Provider Demographics
NPI:1093065161
Name:VALLADARES, ARMANDO (SAC)
Entity Type:Individual
Prefix:DR
First Name:ARMANDO
Middle Name:
Last Name:VALLADARES
Suffix:
Gender:M
Credentials:SAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 93 RD ST APT 402
Mailing Address - Street 2:
Mailing Address - City:BAY HARBOR ISLD
Mailing Address - State:FL
Mailing Address - Zip Code:33154
Mailing Address - Country:US
Mailing Address - Phone:786-301-5301
Mailing Address - Fax:
Practice Address - Street 1:1075 93RD ST APT 402
Practice Address - Street 2:
Practice Address - City:BAY HARBOR ISLANDS
Practice Address - State:FL
Practice Address - Zip Code:33154-2352
Practice Address - Country:US
Practice Address - Phone:786-301-5301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ12-121246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant