Provider Demographics
NPI:1578069225
Name:GARCED DEL VALLE, KELVIN DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:KELVIN
Middle Name:DANIEL
Last Name:GARCED DEL VALLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 RED MAPLE CT
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-4413
Mailing Address - Country:US
Mailing Address - Phone:787-361-2227
Mailing Address - Fax:
Practice Address - Street 1:216 RED MAPLE CT
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-4413
Practice Address - Country:US
Practice Address - Phone:787-361-2227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1578069225207L00000X
390200000X
PR21680207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty