Individual
JOEL JOSUE VALLENILLA TOLOSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
14047 WALCOTT AVE, ORLANDO, FL 32827-7471
(407) 272-8505
Mailing address
14047 WALCOTT AVE, ORLANDO, FL 32827-7471
(407) 272-8505
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
17-398
FL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
09/01/2019
Last updated
03/05/2021
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