Provider Demographics
NPI:1407167430
Name:VALLADARES, MICHAEL G (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:G
Last Name:VALLADARES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:5101 SW 8TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:306-262-6060
Mailing Address - Fax:305-262-6038
Practice Address - Street 1:11760 SW 40TH STREET
Practice Address - Street 2:SUITE 403
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175
Practice Address - Country:US
Practice Address - Phone:305-402-4563
Practice Address - Fax:305-918-1077
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2024-03-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLOS11915207RG0100X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014443500Medicaid