Provider Demographics
NPI:1881816429
Name:VALDES, NEYDA
Entity Type:Individual
Prefix:
First Name:NEYDA
Middle Name:
Last Name: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:ALTURAS DE RIO GRANDE
Mailing Address - Street 2:CALLE 12 N 646
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745
Mailing Address - Country:US
Mailing Address - Phone:787-613-5723
Mailing Address - Fax:
Practice Address - Street 1:HOSP PSIQUIATRIA DR RAMON FERNANDEZ MARINA
Practice Address - Street 2:BO MONACILLOS
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00922
Practice Address - Country:US
Practice Address - Phone:787-766-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR661225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist