Provider Demographics
NPI:1982023743
Name:DEL VALLE PATRON, PAOLA MERCEDES (AP, DIPL OM)
Entity Type:Individual
Prefix:
First Name:PAOLA
Middle Name:MERCEDES
Last Name:DEL VALLE PATRON
Suffix:
Gender:F
Credentials:AP, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 WALLACE STREET
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134
Mailing Address - Country:US
Mailing Address - Phone:305-775-4848
Mailing Address - Fax:
Practice Address - Street 1:299 ALHAMBRA CIRCLE, SUITE 316
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134
Practice Address - Country:US
Practice Address - Phone:786-542-5426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3340171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist