Provider Demographics
NPI:1588013205
Name:FIORITA VALENTINO LLC
Entity type:Organization
Organization Name:FIORITA VALENTINO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:FIORITA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-512-2082
Mailing Address - Street 1:365 MACON DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-1209
Mailing Address - Country:US
Mailing Address - Phone:203-512-2082
Mailing Address - Fax:
Practice Address - Street 1:246 FEDERAL RD
Practice Address - Street 2:C23A
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2647
Practice Address - Country:US
Practice Address - Phone:203-512-2082
Practice Address - Fax:475-282-4168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000345171100000X
NY015327174400000X
CT004388174400000X
NY003049171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty