Organization Name: | ADVANCED ORTHO & SPORTS MED |
NPI Number: | 1265807598 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RICHARD G VALENZUELA (MD/OWNER) |
Mailing Address: | 1639 N Volusia Ave Orange City |
State: | FL US |
Postal Code: | 327633843 |
Phone Number: | 3867752012 |
Fax Number: | |
NPI Enumeration Date: | 12/11/2015 |
NPI Last Update Date: | 05/09/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |