Provider Demographics
NPI:1164143178
Name:RICHARD VALDES, O.D., P.A.
Entity Type:Organization
Organization Name:RICHARD VALDES, O.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:305-360-1646
Mailing Address - Street 1:4308 DIAMOND ROW
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-3112
Mailing Address - Country:US
Mailing Address - Phone:305-360-1646
Mailing Address - Fax:
Practice Address - Street 1:1200 S FEDERAL HWY
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33441-7037
Practice Address - Country:US
Practice Address - Phone:954-281-1253
Practice Address - Fax:754-227-0784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty