Provider Demographics
NPI:1992120224
Name:VALERIO, ANASELI (MA-46547)
Entity type:Individual
Prefix:
First Name:ANASELI
Middle Name:
Last Name:VALERIO
Suffix:
Gender:F
Credentials:MA-46547
Other - Prefix:
Other - First Name:ANASELI
Other - Middle Name:
Other - Last Name:VALERIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA-46547
Mailing Address - Street 1:6801 NW 77TH AVE STE 309
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33166-2848
Mailing Address - Country:US
Mailing Address - Phone:305-748-4783
Mailing Address - Fax:305-748-4805
Practice Address - Street 1:6801 NW 77TH AVE STE 309
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33166-2848
Practice Address - Country:US
Practice Address - Phone:305-748-4783
Practice Address - Fax:305-748-4805
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA-46547390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program