Provider Demographics
NPI:1538694815
Name:PUJOL LOPEZ, VALIA
Entity Type:Individual
Prefix:
First Name:VALIA
Middle Name:
Last Name:PUJOL LOPEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15042 SW 34TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33185-4921
Mailing Address - Country:US
Mailing Address - Phone:305-303-7881
Mailing Address - Fax:
Practice Address - Street 1:10818 SW 240TH LN
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-4700
Practice Address - Country:US
Practice Address - Phone:305-303-7881
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst