Provider Demographics
NPI:1619018769
Name:VALDES, DANIEL (OD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:VALDES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19501 BISCAYNE BLVD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33180-2342
Mailing Address - Country:US
Mailing Address - Phone:305-935-3937
Mailing Address - Fax:305-935-2976
Practice Address - Street 1:19501 BISCAYNE BLVD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-2342
Practice Address - Country:US
Practice Address - Phone:305-935-3937
Practice Address - Fax:305-935-2976
Is Sole Proprietor?:No
Enumeration Date:2007-02-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 3526152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist