Provider Demographics
NPI:1558360156
Name:VALENTIN MARI, MARIA DE LOS ANGELES (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:DE LOS ANGELES
Last Name:VALENTIN MARI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:VALENTIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:609 AVE TITO CASTRO
Mailing Address - Street 2:PMB 295 STE 102
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00716-0200
Mailing Address - Country:US
Mailing Address - Phone:787-457-5150
Mailing Address - Fax:
Practice Address - Street 1:909 AVE TITO CASTRO STE 609
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4721
Practice Address - Country:US
Practice Address - Phone:787-844-9101
Practice Address - Fax:787-457-5150
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13555174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022413Medicare PIN
PRI26573Medicare UPIN