Provider Demographics
NPI:1750125456
Name:ESTEVEZ VALDES, ANA
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:ESTEVEZ VALDES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 FOXCROFT RD
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4185
Mailing Address - Country:US
Mailing Address - Phone:954-559-6301
Mailing Address - Fax:
Practice Address - Street 1:3427 FOXCROFT RD
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-4185
Practice Address - Country:US
Practice Address - Phone:954-559-6301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL24-349228106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician