Provider Demographics
NPI:1629616818
Name:FIGUEROA VALENTIN, RAISA
Entity Type:Individual
Prefix:
First Name:RAISA
Middle Name:
Last Name:FIGUEROA VALENTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 COLONY CLUB DR APT 302
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-7816
Mailing Address - Country:US
Mailing Address - Phone:787-218-8796
Mailing Address - Fax:
Practice Address - Street 1:4971 LE CHALET BLVD STE 100
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33436-1418
Practice Address - Country:US
Practice Address - Phone:561-733-5590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-18
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13005111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor