Provider Demographics
NPI:1053398727
Name:DEL VALLE, EFRAIN (MD)
Entity type:Individual
Prefix:DR
First Name:EFRAIN
Middle Name:
Last Name:DEL VALLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:GL14 AVE CAMPO RICO
Mailing Address - Street 2:COUNTRY CLUB
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00982-2675
Mailing Address - Country:US
Mailing Address - Phone:787-276-2545
Mailing Address - Fax:
Practice Address - Street 1:GL14 AVE CAMPO RICO
Practice Address - Street 2:COUNTRY CLUB
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00982-2675
Practice Address - Country:US
Practice Address - Phone:787-276-2545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-23
Last Update Date:2010-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR93732084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE63356Medicare UPIN
PR0081844Medicare PIN