Provider Demographics
NPI:1245370675
Name:VALDEZ, MARIBEL CINTRON (OTR)
Entity type:Individual
Prefix:MRS
First Name:MARIBEL
Middle Name:CINTRON
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 CENTRAL PARKWAY
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32724-3364
Mailing Address - Country:US
Mailing Address - Phone:386-822-9132
Mailing Address - Fax:386-822-9132
Practice Address - Street 1:1202 CENTRAL PKWY.
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32724
Practice Address - Country:US
Practice Address - Phone:386-626-2495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT0003267225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL8886261Medicaid