Provider Demographics
NPI:1902486665
Name:VALLADARES, AUDREY DE LA CARIDAD (RN)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:DE LA CARIDAD
Last Name:VALLADARES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6365 SW 8TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4842
Mailing Address - Country:US
Mailing Address - Phone:305-762-0452
Mailing Address - Fax:
Practice Address - Street 1:7500 NW 25TH ST STE 114
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33122-1721
Practice Address - Country:US
Practice Address - Phone:305-593-8355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9474418163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL9474418OtherREGISTERED NURSE