Individual
EUGENE RAPHAEL VALENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
235 CARMEL DR, FORT WALTON BEACH, FL 32547-1957
(850) 862-3141
(850) 862-7732
Mailing address
235 CARMEL DR, FORT WALTON BEACH, FL 32547-1957
(850) 862-3141
(850) 862-7732
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
ME12756
FL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME12756
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
052428000
—
FL
01
—
46079
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/18/2006
Last updated
01/19/2010
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