Provider Demographics
NPI:1679966097
Name:DV HEALTHCARE SERVICES, INC
Entity type:Organization
Organization Name:DV HEALTHCARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAMARIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VALDES
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:305-490-8817
Mailing Address - Street 1:1280 W 46TH ST
Mailing Address - Street 2:UNIT 107
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3282
Mailing Address - Country:US
Mailing Address - Phone:305-490-8817
Mailing Address - Fax:
Practice Address - Street 1:1280 W 46TH ST
Practice Address - Street 2:UNIT 107
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3282
Practice Address - Country:US
Practice Address - Phone:305-490-8817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9293928363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty