Basic Information
| Provider Information | |||||||||
| NPI: | 1972924819 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VALDES HECHEVARRIA | ||||||||
| FirstName: | JAYLER | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11255 SW 211TH ST | ||||||||
| Address2: | AMERICAN CARE OF SOUTH FLORIDA, INC. | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331892240 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052780200 | ||||||||
| FaxNumber: | 7862350145 | ||||||||
| Practice Location | |||||||||
| Address1: | 1521 NW 54TH ST | ||||||||
| Address2: | AMERICAN CARE OF SOUTH FLORIDA, INC. | ||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331423807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7865940000 | ||||||||
| FaxNumber: | 7869552216 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2013 | ||||||||
| LastUpdateDate: | 12/19/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | ARNP-9338953 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | ARNP-9338953 | 01 | FL | PROFESSIONAL LICENSE | OTHER |