Provider Demographics
NPI:1720080609
Name:DEL VALLE, ALEJANDRO (DO)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:
Last Name:DEL VALLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4308 ALTON ROAD
Mailing Address - Street 2:SUITE 860
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2910
Mailing Address - Country:US
Mailing Address - Phone:305-604-2888
Mailing Address - Fax:305-604-2886
Practice Address - Street 1:4308 ALTON ROAD
Practice Address - Street 2:SUITE 860
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2910
Practice Address - Country:US
Practice Address - Phone:305-604-2888
Practice Address - Fax:305-604-2886
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8881207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL270573700Medicaid
FL270573700Medicaid
FLU4126Medicare ID - Type UnspecifiedIND MC
FLI24103Medicare UPIN