Provider Demographics
NPI:1063408946
Name:VALENTIN, EDWIN
Entity type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:
Last Name:VALENTIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 71 BOX 7619
Mailing Address - Street 2:
Mailing Address - City:CAYEY
Mailing Address - State:PR
Mailing Address - Zip Code:00736-9575
Mailing Address - Country:US
Mailing Address - Phone:407-765-6131
Mailing Address - Fax:787-715-7332
Practice Address - Street 1:RD. #1 KM 49.0
Practice Address - Street 2:
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739-0073
Practice Address - Country:US
Practice Address - Phone:787-714-1111
Practice Address - Fax:787-715-7332
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS385521835P1200X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy