Provider Demographics
NPI:1467101212
Name:VALDES, BRIAN (APRN)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:VALDES
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 NW 87TH AVE APT 305
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-3432
Mailing Address - Country:US
Mailing Address - Phone:305-467-1287
Mailing Address - Fax:
Practice Address - Street 1:854 NW 87TH AVE APT 305
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-3432
Practice Address - Country:US
Practice Address - Phone:305-467-1287
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11017306363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care