Provider Demographics
NPI:1710935259
Name:VALDES, MARIA DEL CARMEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:DEL CARMEN
Last Name:VALDES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9774 SW 24TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33165-7574
Mailing Address - Country:US
Mailing Address - Phone:305-220-3600
Mailing Address - Fax:305-220-8191
Practice Address - Street 1:9774 SW 24TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-7574
Practice Address - Country:US
Practice Address - Phone:305-220-3600
Practice Address - Fax:305-220-8191
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME77937208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD00584OtherDOCTOR CARE
FL256165400Medicaid
FL36176OtherNHP
FL49989OtherBC/BS
FL36176OtherNHP
FL256165400Medicaid
FLH04343Medicare UPIN