Provider Demographics
NPI:1184766479
Name:FRANCO DELVALLE, SANDRA
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:FRANCO DELVALLE
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:PMB 160 CALLE 39 UU1 SANTA JUANITA
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956
Mailing Address - Country:US
Mailing Address - Phone:787-779-0700
Mailing Address - Fax:787-779-0700
Practice Address - Street 1:PMB 160 CALLE 39 UU1 SANTA JUANITA
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956
Practice Address - Country:US
Practice Address - Phone:787-779-0700
Practice Address - Fax:787-779-0700
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2330103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
100686OtherLA CRUZ AZUL DE PR
2885OtherAPS HEALTHCARE INC
2886OtherHUMANA INC
219105OtherPREFERRED HEALTH
57059OtherTRIPLE S
A097OtherINTERNATIONAL MEDICAL CAR
2885OtherAPS HEALTHCARE INC
0057059Medicare ID - Type Unspecified