Provider Demographics
NPI:1457564734
Name:MUEHL, VALDELINE IRMA (MD)
Entity Type:Individual
Prefix:DR
First Name:VALDELINE
Middle Name:IRMA
Last Name:MUEHL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VALDELINE
Other - Middle Name:IRMA
Other - Last Name:PHOEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14690 SPRING HILL DR
Mailing Address - Street 2:SUITE 100 ATTN:CREDENTIALING
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-799-0046
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:2191 9TH AVE N STE 110
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713-7147
Practice Address - Country:US
Practice Address - Phone:727-216-6188
Practice Address - Fax:727-216-6242
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23695207Q00000X
FLME113499207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3810016286Medicaid
FLGI860YMedicare PIN
FL4272951Medicare UPIN