Provider Demographics
NPI:1407999568
Name:VALENCIA, ERWIN BENEDICT (DPT, ATC, CSCS)
Entity type:Individual
Prefix:MR
First Name:ERWIN
Middle Name:BENEDICT
Last Name:VALENCIA
Suffix:
Gender:M
Credentials:DPT, ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1734 LARAMIE ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8841
Mailing Address - Country:US
Mailing Address - Phone:917-326-1682
Mailing Address - Fax:
Practice Address - Street 1:711 OLD SAW MILL RIVER RD
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-6701
Practice Address - Country:US
Practice Address - Phone:212-465-6741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2255A2300X
FLPT23447225100000X
NY021373225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
070202203OtherNATABOC CERTIFICATION