Provider Demographics
NPI:1487867735
Name:VALLES, MARIA LUISA (NURSE)
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:LUISA
Last Name:VALLES
Suffix:
Gender:F
Credentials:NURSE
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:LUISA
Other - Last Name:VALLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NURSE
Mailing Address - Street 1:P O BOX 235
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-0235
Mailing Address - Country:US
Mailing Address - Phone:787-873-6397
Mailing Address - Fax:787-832-2325
Practice Address - Street 1:ASSMCA
Practice Address - Street 2:410 AVE HOSTOSSUITE 7
Practice Address - City:MAYAGUES
Practice Address - State:PR
Practice Address - Zip Code:00682-1522
Practice Address - Country:US
Practice Address - Phone:787-832-2325
Practice Address - Fax:787-832-2325
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR010745163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent