Basic Information
| Provider Information | |||||||||
| NPI: | 1194448167 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VALENTIN | ||||||||
| FirstName: | MA CATHERINE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4760 TRIBUTE TRL | ||||||||
| Address2: | |||||||||
| City: | KISSIMMEE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 347465674 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4079202668 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1745 N MILLS AVE | ||||||||
| Address2: | |||||||||
| City: | ORLANDO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 328031876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4078417151 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/23/2022 | ||||||||
| LastUpdateDate: | 09/23/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 11022017 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.