Provider Demographics
NPI:1598052391
Name:VALDES SHAW, CECILIA (DOM)
Entity Type:Individual
Prefix:DR
First Name:CECILIA
Middle Name:
Last Name:VALDES SHAW
Suffix:
Gender:F
Credentials:DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 W 41ST ST
Mailing Address - Street 2:#414
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-3641
Mailing Address - Country:US
Mailing Address - Phone:305-538-8998
Mailing Address - Fax:
Practice Address - Street 1:333 W 41ST ST
Practice Address - Street 2:#414
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-3641
Practice Address - Country:US
Practice Address - Phone:305-538-8998
Practice Address - Fax:305-538-1255
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP2963171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist