Provider Demographics
NPI:1992006514
Name:VALENTINO, MICHELLE A
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:A
Last Name:VALENTINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 E INDIANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-5111
Mailing Address - Country:US
Mailing Address - Phone:561-741-5566
Mailing Address - Fax:
Practice Address - Street 1:1000 E INDIANTOWN RD
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5111
Practice Address - Country:US
Practice Address - Phone:561-741-5566
Practice Address - Fax:561-295-5237
Is Sole Proprietor?:No
Enumeration Date:2010-11-12
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336168363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF336168OtherNYS LICENSE
NY00695941Medicaid
NY331947Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NY331009Medicare Oscar/Certification
NY00695941Medicaid
NY331946Medicare Oscar/Certification
NY331978Medicare Oscar/Certification
NY331954Medicare Oscar/Certification
NYG100000410Medicare Oscar/Certification
NY331943Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
NY331945Medicare Oscar/Certification
NY331043Medicare Oscar/Certification