Provider Demographics
NPI:1528092145
Name:DEL VALLE, ANTONIO I (MD)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:I
Last Name:DEL VALLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:253 CALLE SIERRA MORENA
Mailing Address - Street 2:SUITE 157
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-5539
Mailing Address - Country:US
Mailing Address - Phone:787-756-4020
Mailing Address - Fax:787-777-3227
Practice Address - Street 1:DEPARTMENT OF PEDIATRICS
Practice Address - Street 2:UNIVERSITY PEDIATRICS HOSPITAL, OFFICE 1 A 29
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00936-5067
Practice Address - Country:US
Practice Address - Phone:787-756-4020
Practice Address - Fax:787-777-3227
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR12677174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist