Provider Demographics
NPI:1174508717
Name:DEL VALLE, FELIPE A (MD)
Entity Type:Individual
Prefix:
First Name:FELIPE
Middle Name:A
Last Name:DEL 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 1:2350 SW 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1160
Mailing Address - Country:US
Mailing Address - Phone:786-263-0527
Mailing Address - Fax:786-263-0529
Practice Address - Street 1:2350 SW 84TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1160
Practice Address - Country:US
Practice Address - Phone:786-263-0527
Practice Address - Fax:786-263-0529
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME50226207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL061432700Medicaid
FL07692Medicare ID - Type Unspecified
FLE21401Medicare UPIN