Provider Demographics
NPI:1902368608
Name:VALERO, RAIR JOSE (MD)
Entity type:Individual
Prefix:
First Name:RAIR
Middle Name:JOSE
Last Name:VALERO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAIR
Other - Middle Name:JOSE
Other - Last Name:VALERO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2800 S SEACREST BLVD STE 140
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7943
Mailing Address - Country:US
Mailing Address - Phone:561-734-2746
Mailing Address - Fax:833-626-1934
Practice Address - Street 1:2800 S SEACREST BLVD STE 140
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7943
Practice Address - Country:US
Practice Address - Phone:561-734-2746
Practice Address - Fax:833-626-1934
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-02
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLME165209208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program