Provider Demographics
NPI:1598035669
Name:JULIO J VALDES, M.D.,PA
Entity Type:Organization
Organization Name:JULIO J VALDES, M.D.,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR - OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:VALDES
Authorized Official - Last Name:MORRONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-879-3530
Mailing Address - Street 1:4506 N ARMENIA AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33603-2732
Mailing Address - Country:US
Mailing Address - Phone:813-879-3530
Mailing Address - Fax:813-874-6608
Practice Address - Street 1:4506 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-2732
Practice Address - Country:US
Practice Address - Phone:813-879-3530
Practice Address - Fax:813-874-6608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-06
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL113514700Medicaid