Provider Demographics
NPI:1255519195
Name:VALDEON, CIRO ALBERTO (ED S)
Entity type:Individual
Prefix:
First Name:CIRO
Middle Name:ALBERTO
Last Name:VALDEON
Suffix:
Gender:M
Credentials:ED S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 W 66TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-6646
Mailing Address - Country:US
Mailing Address - Phone:305-558-2480
Mailing Address - Fax:
Practice Address - Street 1:430 W 66TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-6646
Practice Address - Country:US
Practice Address - Phone:305-558-2480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-02
Last Update Date:2008-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS 610103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool