Provider Demographics
NPI:1154761088
Name:VALENTIN, JUAN N (MD)
Entity type:Individual
Prefix:
First Name:JUAN
Middle Name:N
Last Name:VALENTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF PUERTO RICO DEPARTMENT OF PM&R
Mailing Address - Street 2:OFFICE A- 204 MEDICAL SCIENCE CAMPUS
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00935-0001
Mailing Address - Country:US
Mailing Address - Phone:787-649-0095
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSIDAD DE PUERTO RICO RECINTO DE CIENCIAS MEDICAS,
Practice Address - Street 2:DEPARTAMENTO DE PM&R 2DO PISO OFICINA A204
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-0001
Practice Address - Country:US
Practice Address - Phone:787-758-2525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-25
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19648261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4575810OtherDRIVER LICENSE