Individual
JOSE VALENTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
701 W COCOA BEACH CSWY, COCOA BEACH, FL 32931-3585
(321) 434-8777
Mailing address
3300 S FISKE BLVD, ROCKLEDGE, FL 32955-4306
(321) 434-8777
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9107281
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9107281
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120461300
—
FL
01
—
NV683
MEDICARE
FL
Enumeration date
07/01/2013
Last updated
08/22/2024
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