Provider Demographics
NPI:1649662362
Name:HALLUX CORPORATION
Entity type:Organization
Organization Name:HALLUX CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDICIESO-DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:305-986-4584
Mailing Address - Street 1:7701 SW 180TH TER
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-6218
Mailing Address - Country:US
Mailing Address - Phone:305-986-4584
Mailing Address - Fax:
Practice Address - Street 1:85 GRAND CANAL DR STE 407
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2571
Practice Address - Country:US
Practice Address - Phone:786-322-3111
Practice Address - Fax:305-554-4408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 3419213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty