Basic Information
| Provider Information | |||||||||
| NPI: | 1518168798 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VALENTIN | ||||||||
| FirstName: | MARITZA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 250506 | ||||||||
| Address2: | |||||||||
| City: | AGUADILLA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 006040506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878302707 | ||||||||
| FaxNumber: | 7878300465 | ||||||||
| Practice Location | |||||||||
| Address1: | AVE AGUSTIN RAMOS CALERO | ||||||||
| Address2: | 737 | ||||||||
| City: | ISABELA | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7878302707 | ||||||||
| FaxNumber: | 7878300465 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246QM0706X | 5646 | PR | Y | Technologists, Technicians & Other Technical Service Providers | Spec/Tech, Pathology | Medical Technologist |
No ID Information.