Provider Demographics
NPI:1902890809
Name:VALDES, MARIA T (MD)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:T
Last Name:VALDES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6101 PINE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-3900
Mailing Address - Country:US
Mailing Address - Phone:239-348-4509
Mailing Address - Fax:239-348-4529
Practice Address - Street 1:6101 PINE RIDGE RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-3900
Practice Address - Country:US
Practice Address - Phone:239-348-4509
Practice Address - Fax:239-348-4529
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY205635-1207RG0100X
FLME72022207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL16159VOtherMEDICARE PTAN
FL272783800Medicaid
FL272783800Medicaid