Provider Demographics
NPI:1356571236
Name:SANCHEZ VALDIVIESO, BERTHA ELVIRA (MD)
Entity type:Individual
Prefix:
First Name:BERTHA
Middle Name:ELVIRA
Last Name:SANCHEZ VALDIVIESO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SW SOUTH RIVER DR APT 608
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33130-1413
Mailing Address - Country:US
Mailing Address - Phone:256-676-0902
Mailing Address - Fax:
Practice Address - Street 1:4320 SEMINARY RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22304-1535
Practice Address - Country:US
Practice Address - Phone:703-504-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-25
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD23775207R00000X, 208M00000X
DEC1-0012261207R00000X
MI4301095145207R00000X
OH35.127242208M00000X
VA0101261134207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist