Provider Demographics
NPI:1346277522
Name:VALVERDE, JOSE LUIS (BS)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:LUIS
Last Name:VALVERDE
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14818 SW 81ST ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1555
Mailing Address - Country:US
Mailing Address - Phone:305-773-8157
Mailing Address - Fax:
Practice Address - Street 1:654 NE 9TH PL
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4934
Practice Address - Country:US
Practice Address - Phone:305-248-3488
Practice Address - Fax:305-248-6558
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL021012200Medicaid
FLCBHCMS100296OtherFLORIDA CERTIFICATION BOARD