Individual
MR. LARRY VALDES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CEO
Contact information
Practice address
4402 W MINNEHAHA ST, TAMPA, FL 33614
(813) 841-9823
(813) 349-0029
Mailing address
4402 W MINNEHAHA ST, TAMPA, FL 33614-3638
(813) 841-9823
(813) 349-0029
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33614
—
FL
Enumeration date
08/11/2017
Last updated
07/21/2022
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