Provider Demographics
NPI:1346775020
Name:GRISALES, VALENTINA (BS)
Entity Type:Individual
Prefix:MRS
First Name:VALENTINA
Middle Name:
Last Name:GRISALES
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4306 SW 119TH AVE
Mailing Address - Street 2:APT 301
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-7991
Mailing Address - Country:US
Mailing Address - Phone:786-553-7550
Mailing Address - Fax:
Practice Address - Street 1:4306 SW 119TH AVE
Practice Address - Street 2:APT 301
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-7991
Practice Address - Country:US
Practice Address - Phone:786-553-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other