Provider Demographics
NPI:1699760470
Name:VALENTINE, VERONICA (DC)
Entity type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:
Last Name:VALENTINE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10113 SUNSET STRIP
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-2619
Mailing Address - Country:US
Mailing Address - Phone:954-530-8507
Mailing Address - Fax:954-652-1538
Practice Address - Street 1:10113 SUNSET STRIP
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-2619
Practice Address - Country:US
Practice Address - Phone:954-530-8507
Practice Address - Fax:954-652-1538
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-16
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006083111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10749944OtherCAQH PROVIDER NUMBER
FL055876100Medicaid
FL055876100Medicaid
FL10749944OtherCAQH PROVIDER NUMBER