Basic Information
| Provider Information | |||||||||
| NPI: | 1720656127 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VALOUR MEDICAL INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2104 BELCARA CT | ||||||||
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| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334111476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8134956434 | ||||||||
| FaxNumber: | 5615575321 | ||||||||
| Practice Location | |||||||||
| Address1: | 2005 PAN AM CIR STE 120 | ||||||||
| Address2: | |||||||||
| City: | TAMPA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 336072529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7273866495 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2021 | ||||||||
| LastUpdateDate: | 06/14/2021 | ||||||||
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| AuthorizedOfficialLastName: | OLIVER | ||||||||
| AuthorizedOfficialFirstName: | EDDIE | ||||||||
| AuthorizedOfficialMiddleName: | EUGENE | ||||||||
| AuthorizedOfficialTitleorPosition: | PRES. | ||||||||
| AuthorizedOfficialTelephone: | 8134956434 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 06/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.