Individual
DEBORAH VALDIVIESO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1022 FLORIDA AVE S, ROCKLEDGE, FL 32955-2145
(321) 634-3688
(321) 504-0955
Mailing address
1022 FLORIDA AVE S, ROCKLEDGE, FL 32955-2145
(321) 634-3688
(321) 504-0955
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
PT3790
FL
225100000X
Physical Therapist
PT3790
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
882160700
—
FL
05
—
889522800
—
FL
Enumeration date
03/26/2007
Last updated
06/05/2008
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