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Organization

JUDITH VALENCIA MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JUDITH VALENCIA MD (PRESIDENT)
(305) 222-9154
Entity
Organization

Contact information

Practice address
9804 SW 40TH ST, MIAMI, FL 33165-3912
(305) 222-9154
(305) 222-9155
Mailing address
9804 SW 40TH ST, MIAMI, FL 33165-3912
(305) 222-9154
(305) 222-9155

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
ME98844
FL
208D00000X
General Practice Physician
Primary
ME98844
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
23624
BLUE CROSS/ BLUE SHIELD
FL
05
279199400
FL
01
ME98844
FLORIDA LICENSE
FL
Enumeration date
06/23/2009
Last updated
11/04/2022
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