Provider Demographics
NPI:1679175475
Name:VALDES RODRIGUEZ, ORLANDO DE JESUS
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:DE JESUS
Last Name:VALDES RODRIGUEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 N 40TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-3360
Mailing Address - Country:US
Mailing Address - Phone:305-282-1611
Mailing Address - Fax:
Practice Address - Street 1:2701 N 40TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-3360
Practice Address - Country:US
Practice Address - Phone:305-282-1611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11010060363LF0000X
TXAPRN1027787363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily