Organization
ADVANCED ORTHO & SPORTS MED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD G VALENZUELA (MD/OWNER)
(352) 284-5181
Entity
Organization
Contact information
Practice address
1639 N VOLUSIA AVE, ORANGE CITY, FL 32763-3843
(386) 775-2012
Mailing address
1639 N VOLUSIA AVE, ORANGE CITY, FL 32763-3843
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
12/11/2015
Last updated
05/09/2016
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