Provider Demographics
NPI:1730309915
Name:VALLES, JOSE A (MD)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:A
Last Name:VALLES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO. BOX 974
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-0974
Mailing Address - Country:US
Mailing Address - Phone:787-744-4499
Mailing Address - Fax:787-746-2454
Practice Address - Street 1:AVE. DEGETAU 500 TOVRE HIMA PLAZA
Practice Address - Street 2:SUITE 503-504
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-744-4499
Practice Address - Fax:787-746-2454
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR10594225B00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No225B00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPulmonary Function Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR20385OtherTRIPLE SS
PR20385OtherTRIPLE SS