Provider Demographics
NPI:1841699659
Name:VALLADARES, GISELLE (ARNP)
Entity type:Individual
Prefix:
First Name:GISELLE
Middle Name:
Last Name:VALLADARES
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 N FEDERAL HWY
Mailing Address - Street 2:SUITE 270
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-4917
Mailing Address - Country:US
Mailing Address - Phone:561-910-1251
Mailing Address - Fax:561-910-1047
Practice Address - Street 1:5301 N FEDERAL HWY
Practice Address - Street 2:SUITE 270
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-4917
Practice Address - Country:US
Practice Address - Phone:561-910-1251
Practice Address - Fax:561-910-1047
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9202834364SP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily