Provider Demographics
NPI:1376154047
Name:VALENTINE, RICHARD JAMES (PARAMEDIC)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:JAMES
Last Name:VALENTINE
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2712 MIRACLE PKWY
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-3801
Mailing Address - Country:US
Mailing Address - Phone:239-896-8592
Mailing Address - Fax:
Practice Address - Street 1:2712 MIRACLE PKWY
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-3801
Practice Address - Country:US
Practice Address - Phone:239-896-8592
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL528229146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic