Provider Demographics
NPI:1790880862
Name:VALLES & ASSOCIATES REHABILITATION SERVICES INC
Entity Type:Organization
Organization Name:VALLES & ASSOCIATES REHABILITATION SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JUAN
Authorized Official - Middle Name:I
Authorized Official - Last Name:VALLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-233-7035
Mailing Address - Street 1:12600 SW 120TH ST
Mailing Address - Street 2:STE # 109, 2ND FLR
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33186-9066
Mailing Address - Country:US
Mailing Address - Phone:305-233-7035
Mailing Address - Fax:305-233-7250
Practice Address - Street 1:12600 SW 120TH ST
Practice Address - Street 2:STE #109, 2ND FLR
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33186-9066
Practice Address - Country:US
Practice Address - Phone:305-233-7035
Practice Address - Fax:305-233-7250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC3666335V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
1487755385Medicare PIN