Basic Information
| Provider Information | |||||||||
| NPI: | 1891899241 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DEL VALLE | ||||||||
| FirstName: | ENID | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1047 CARITE STREET | ||||||||
| Address2: | URB. VALLES DEL LAGO | ||||||||
| City: | CAGUAS | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00725 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877470246 | ||||||||
| FaxNumber: | 7879775062 | ||||||||
| Practice Location | |||||||||
| Address1: | SAN JORGE MEDICAL OFFICE BUILDING SAN JORGE STREET 252 | ||||||||
| Address2: | SUITE 407 | ||||||||
| City: | SAN JUAN | ||||||||
| State: | PR | ||||||||
| PostalCode: | 00912 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7877281415 | ||||||||
| FaxNumber: | 7877281409 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0216X | 11920 | PR | Y | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Rheumatology |
No ID Information.