Provider Demographics
NPI:1124897020
Name:VALENZUELA, VICENTE D (APRN)
Entity type:Individual
Prefix:MR
First Name:VICENTE
Middle Name:D
Last Name:VALENZUELA
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 NW 14TH ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-2137
Mailing Address - Country:US
Mailing Address - Phone:305-243-4917
Mailing Address - Fax:
Practice Address - Street 1:7480 BIRD RD STE 560
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-6657
Practice Address - Country:US
Practice Address - Phone:305-707-5688
Practice Address - Fax:305-760-4149
Is Sole Proprietor?:No
Enumeration Date:2023-12-20
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11030259363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily