Provider Demographics
NPI:1972204089
Name:DEL VALLE FAMILY CLINIC
Entity Type:Organization
Organization Name:DEL VALLE FAMILY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:ALEJANDRO
Authorized Official - Last Name:DEL VALLE DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-385-7001
Mailing Address - Street 1:PO BOX 730
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-0730
Mailing Address - Country:US
Mailing Address - Phone:787-385-7001
Mailing Address - Fax:787-894-6469
Practice Address - Street 1:CALLE SARGENTO ISRAEL MALARET JUARBE
Practice Address - Street 2:#418
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641
Practice Address - Country:US
Practice Address - Phone:787-894-5919
Practice Address - Fax:787-894-6469
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEL VALLE FAMILY CLINIC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-15
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Multi-Specialty
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty