Provider Demographics
NPI:1619770336
Name:VALDES ALFONSO, GRETEL (MSN)
Entity type:Individual
Prefix:
First Name:GRETEL
Middle Name:
Last Name:VALDES ALFONSO
Suffix:
Gender:F
Credentials:MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8145 NW 7TH ST APT 404
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-4096
Mailing Address - Country:US
Mailing Address - Phone:786-217-7970
Mailing Address - Fax:
Practice Address - Street 1:8145 NW 7TH ST APT 404
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126-4096
Practice Address - Country:US
Practice Address - Phone:786-217-7970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038505363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily