Provider Demographics
NPI:1275175432
Name:VALDES, EDY YAMIL (THERAPIST)
Entity Type:Individual
Prefix:
First Name:EDY
Middle Name:YAMIL
Last Name:VALDES
Suffix:
Gender:M
Credentials:THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2951 SW 135TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6622
Mailing Address - Country:US
Mailing Address - Phone:754-246-7524
Mailing Address - Fax:
Practice Address - Street 1:2951 SW 135TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6622
Practice Address - Country:US
Practice Address - Phone:754-246-7524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist