Provider Demographics
NPI:1912093378
Name:VALENTINE, HODA D
Entity Type:Individual
Prefix:
First Name:HODA
Middle Name:D
Last Name:VALENTINE
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 1:210 SALZEDO ST
Mailing Address - Street 2:
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1020
Mailing Address - Country:US
Mailing Address - Phone:561-670-8626
Mailing Address - Fax:561-795-8557
Practice Address - Street 1:210 SALZEDO ST
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1020
Practice Address - Country:US
Practice Address - Phone:561-670-8626
Practice Address - Fax:561-795-8557
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL675530596Medicaid