Provider Demographics
NPI:1184266231
Name:MAXIMUM SUSTAINED PERFORMANCE
Entity type:Organization
Organization Name:MAXIMUM SUSTAINED PERFORMANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLELUNGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-889-5754
Mailing Address - Street 1:759 SW FEDERAL HWY STE 317
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2923
Mailing Address - Country:US
Mailing Address - Phone:305-209-3633
Mailing Address - Fax:
Practice Address - Street 1:759 SW FEDERAL HWY STE 317
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2923
Practice Address - Country:US
Practice Address - Phone:305-209-3633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-10
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization