Organization
RUBEN B VALLEJO MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUBEN VALLEJO (PRESIDENT)
(954) 581-4111
Entity
Organization
Contact information
Practice address
1777 S ANDREWS AVE, SUITE 201, FT LAUDERDALE, FL 33316-2517
(954) 581-4111
Mailing address
PO BOX 19708, PLANTATION, FL 33318-0708
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038592100
—
FL
Enumeration date
08/09/2011
Last updated
11/28/2016
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