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Individual

DR. GUILLERMO JOSE VALENZUELA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
140 SW 84TH AVE, SUITE B, PLANTATION, FL 33324-2736
(954) 476-2338
(954) 476-5695
Mailing address
140 SW 84TH AVE, SUITE B, PLANTATION, FL 33324-2736
(954) 476-2338
(954) 476-5695

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME006617
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
005771
NHP
FL
01
0462952
CIGNA
FL
01
200530
AMERIGROUP
FL
01
222923
AVMED
FL
01
25333
BCBS
FL
05
378648000
FL
01
854422
AETNA
FL
Enumeration date
07/24/2006
Last updated
02/26/2013
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