Provider Demographics
NPI:1144207697
Name:VALENCIA, LUCY (DO)
Entity Type:Individual
Prefix:DR
First Name:LUCY
Middle Name:
Last Name:VALENCIA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12797 FOREST HILL BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4763
Mailing Address - Country:US
Mailing Address - Phone:561-337-8881
Mailing Address - Fax:561-793-5788
Practice Address - Street 1:12797 FOREST HILL BLVD
Practice Address - Street 2:STE B
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4763
Practice Address - Country:US
Practice Address - Phone:561-337-8881
Practice Address - Fax:561-793-5788
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-27
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8098207Q00000X
FLOS 8098207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258639800Medicaid
FLH34176Medicare UPIN