Provider Demographics
NPI:1619559630
Name:VALDEZ, JOHN ROMAN
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ROMAN
Last Name:VALDEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8185 CORPORATE WAY
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6809
Mailing Address - Country:US
Mailing Address - Phone:513-398-7171
Mailing Address - Fax:513-398-8683
Practice Address - Street 1:8185 CORPORATE WAY
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6809
Practice Address - Country:US
Practice Address - Phone:513-398-7171
Practice Address - Fax:513-398-8683
Is Sole Proprietor?:No
Enumeration Date:2021-04-28
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.150072208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics