Organization
PINES FOOT & ANKLE SURGICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE L VALDES DPM (PRESIDENT)
(954) 704-2888
Entity
Organization
Contact information
Practice address
17901 NW 5TH ST, SUITE # 106, PEMBROKE PINES, FL 33029-2810
(954) 704-2888
(954) 704-0227
Mailing address
PO BOX 825892, PEMBROKE PINES, FL 33082-5892
(954) 704-2888
(954) 704-0227
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO-2687
FL
213EP1101X
Primary Podiatric Medicine Podiatrist
PO-2687
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO-2687
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
390463600
—
FL
Enumeration date
02/13/2007
Last updated
08/19/2010
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