Provider Demographics
NPI:1891147732
Name:VALKANAS, ANDREW (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:VALKANAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5070 CARLEY CT
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32583-6514
Mailing Address - Country:US
Mailing Address - Phone:918-409-1407
Mailing Address - Fax:
Practice Address - Street 1:1322 E ALLEN RD
Practice Address - Street 2:APT 14
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-3509
Practice Address - Country:US
Practice Address - Phone:918-409-1407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-04
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN66527207R00000X
390200000X
FLOS18171208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty