Provider Demographics
NPI:1124995717
Name:EITEL, VALERIE
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:EITEL
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 1:1223 RYAN ST FL 32129
Mailing Address - Street 2:
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32129-7483
Mailing Address - Country:US
Mailing Address - Phone:561-985-7474
Mailing Address - Fax:
Practice Address - Street 1:1223 RYAN ST FL 32129
Practice Address - Street 2:
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32129-7483
Practice Address - Country:US
Practice Address - Phone:561-985-7474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty