Provider Demographics
NPI:1295541639
Name:VALERA, AMAURIS (APRN)
Entity type:Individual
Prefix:
First Name:AMAURIS
Middle Name:
Last Name:VALERA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:AMAURIS
Other - Middle Name:MODESTO
Other - Last Name:VALERA SALES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1551 CORDGRASS WAY
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2715
Mailing Address - Country:US
Mailing Address - Phone:561-502-3506
Mailing Address - Fax:
Practice Address - Street 1:1551 CORDGRASS WAY
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2715
Practice Address - Country:US
Practice Address - Phone:561-502-3506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11036723363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner