Individual
DR. MARY ELLEN VALLETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2010 N YOUNG BLVD, CHIEFLAND, FL 32626-1951
(352) 463-2374
(352) 463-4507
Mailing address
911 S MAIN ST, TRENTON, FL 32693-3239
(352) 463-2374
(352) 463-4507
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME90984
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270589300
—
FL
Enumeration date
06/07/2006
Last updated
09/08/2011
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