Provider Demographics
NPI:1790025286
Name:VALDERRAMA, LIBIA M (ARNP)
Entity Type:Individual
Prefix:
First Name:LIBIA
Middle Name:M
Last Name:VALDERRAMA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17894 NW 2ND ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-2806
Mailing Address - Country:US
Mailing Address - Phone:954-430-9898
Mailing Address - Fax:
Practice Address - Street 1:7975 NW 154TH ST STE 420
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5849
Practice Address - Country:US
Practice Address - Phone:305-827-5545
Practice Address - Fax:305-827-5547
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9240950363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily