Provider Demographics
NPI:1790542637
Name:AMADOR VALDES, KETY
Entity Type:Individual
Prefix:
First Name:KETY
Middle Name:
Last Name:AMADOR VALDES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7001 W 35TH AVE UNIT 124
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-7117
Mailing Address - Country:US
Mailing Address - Phone:786-210-5790
Mailing Address - Fax:
Practice Address - Street 1:7001 W 35TH AVE UNIT 124
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-7117
Practice Address - Country:US
Practice Address - Phone:786-210-5790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-05
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician