1972924819 NPI number — JAYLER VALDES HECHEVARRIA ARNP

Table of content: JAYLER VALDES HECHEVARRIA ARNP (NPI 1972924819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972924819 NPI number — JAYLER VALDES HECHEVARRIA ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VALDES HECHEVARRIA
Provider First Name:
JAYLER
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1972924819
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11255 SW 211TH ST
Provider Second Line Business Mailing Address:
AMERICAN CARE OF SOUTH FLORIDA, INC.
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33189-2240
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
305-278-0200
Provider Business Mailing Address Fax Number:
786-235-0145

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
149 W 21ST ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33010-2615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-558-0765
Provider Business Practice Location Address Fax Number:
786-219-4355
Provider Enumeration Date:
12/19/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  ARNP-9338953 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ARNP-9338953 . This is a "PROFESSIONAL LICENSE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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