Provider Demographics
NPI:1720107477
Name:VALVERDE, CYNTHIA LEE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LEE
Last Name:VALVERDE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 JACARANDA CT
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-4962
Mailing Address - Country:US
Mailing Address - Phone:561-758-4573
Mailing Address - Fax:561-909-2069
Practice Address - Street 1:107 JACARANDA CT
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-4962
Practice Address - Country:US
Practice Address - Phone:561-758-4573
Practice Address - Fax:561-909-2069
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT001439225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL880539300Medicaid