Provider Demographics
NPI:1508851148
Name:MECHANIK, VALERIE CATHERINE (MD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:CATHERINE
Last Name:MECHANIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 W SAINT ISABEL ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6371
Mailing Address - Country:US
Mailing Address - Phone:813-870-3890
Mailing Address - Fax:813-877-8517
Practice Address - Street 1:2901 W SAINT ISABEL ST
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6371
Practice Address - Country:US
Practice Address - Phone:813-870-3890
Practice Address - Fax:813-877-8517
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0043806207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307787Medicare ID - Type Unspecified
D54123Medicare UPIN