Provider Demographics
NPI:1679113187
Name:PITALUGA, VALERIE N (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:N
Last Name:PITALUGA
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8201 PETERS RD STE 1000
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3266
Mailing Address - Country:US
Mailing Address - Phone:786-361-8073
Mailing Address - Fax:
Practice Address - Street 1:8201 PETERS RD STE 1000
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-3266
Practice Address - Country:US
Practice Address - Phone:786-361-8073
Practice Address - Fax:786-442-3644
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-13
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA16976235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105339900Medicaid