Provider Demographics
NPI:1578319331
Name:VALDES, NATALIE (MOT)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:VALDES
Suffix:
Gender:F
Credentials:MOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12007 RITZ CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-2716
Mailing Address - Country:US
Mailing Address - Phone:321-662-6388
Mailing Address - Fax:
Practice Address - Street 1:12007 RITZ CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-2716
Practice Address - Country:US
Practice Address - Phone:321-662-6388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23650225X00000X
CA26378225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist