Basic Information
Provider Information
NPI: 1093842403
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VALENTI
FirstName: PEJAI
MiddleName: JO
NamePrefix:  
NameSuffix:  
Credential: PT
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Mailing Information
Address1: 1325 SAN MARCO BLVD
Address2: SUITE 701
City: JACKSONVILLE
State: FL
PostalCode: 322078568
CountryCode: US
TelephoneNumber: 9048586418
FaxNumber: 9048586490
Practice Location
Address1: 7740 POINT MEADOWS DR
Address2: SUITES 1&2
City: JACKSONVILLE
State: FL
PostalCode: 322569179
CountryCode: US
TelephoneNumber: 9045649594
FaxNumber: 9045649687
Other Information
ProviderEnumerationDate: 02/27/2007
LastUpdateDate: 07/23/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT23231FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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