Provider Demographics
NPI:1962825125
Name:VALENCIA, VICTOR (CCP)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:VALENCIA
Suffix:
Gender:M
Credentials:CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:949 W CALLE ESTRELLA DE NOCHE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85713-1677
Mailing Address - Country:US
Mailing Address - Phone:520-304-2940
Mailing Address - Fax:
Practice Address - Street 1:2251 N INDIAN RUINS RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-5331
Practice Address - Country:US
Practice Address - Phone:520-885-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes242T00000XTechnologists, Technicians & Other Technical Service ProvidersPerfusionist