Provider Demographics
NPI:1730976382
Name:VALLO CORAL SPRINGS PLLC
Entity type:Organization
Organization Name:VALLO CORAL SPRINGS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:COBOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-398-5423
Mailing Address - Street 1:8331 GUNN HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-1608
Mailing Address - Country:US
Mailing Address - Phone:773-398-5423
Mailing Address - Fax:
Practice Address - Street 1:9132 WILES RD FL 33065
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-1993
Practice Address - Country:US
Practice Address - Phone:773-398-5423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental