Provider Demographics
NPI:1215367453
Name:VALDEZ, JESUS RAPISURA JR (PTRP)
Entity Type:Individual
Prefix:MR
First Name:JESUS
Middle Name:RAPISURA
Last Name:VALDEZ
Suffix:JR
Gender:M
Credentials:PTRP
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Mailing Address - Street 1:POB 10003 PMB 1341
Mailing Address - Street 2:
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-8903
Mailing Address - Country:US
Mailing Address - Phone:670-233-4646
Mailing Address - Fax:670-233-4648
Practice Address - Street 1:GHIYEGHI STREET
Practice Address - Street 2:MARIANAS HEALTH LLC BUILDING SAN JOSE
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950-8903
Practice Address - Country:US
Practice Address - Phone:670-233-4646
Practice Address - Fax:670-233-4648
Is Sole Proprietor?:No
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY028270225100000X
MP0023225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist