Provider Demographics
NPI:1275172512
Name:VALDEZ, PEDRO M IV (MA)
Entity Type:Individual
Prefix:MR
First Name:PEDRO
Middle Name:M
Last Name:VALDEZ
Suffix:IV
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 FLORAL DR
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34743-7008
Mailing Address - Country:US
Mailing Address - Phone:517-936-6960
Mailing Address - Fax:
Practice Address - Street 1:385 CENTERPOINTE CIR STE 1301
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-3443
Practice Address - Country:US
Practice Address - Phone:800-509-3090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health