# ADVANCED ORTHO & SPORTS MED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265807598
- **Authorized official:** RICHARD G VALENZUELA (MD/OWNER)
- **Authorized official phone:** (352) 284-5181

## Contact information

- **Practice address:** 1639 N VOLUSIA AVE, ORANGE CITY, FL 32763-3843
- **Practice address phone:** (386) 775-2012
- **Mailing address:** 1639 N VOLUSIA AVE, ORANGE CITY, FL 32763-3843

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/11/2015
- **Last updated:** 05/09/2016