Dr Mary Ellen Valletta, MD | |
2010 N Young Blvd, Chiefland, FL 32626-1951 | |
(352) 463-2374 | |
(352) 463-4507 |
Full Name | Dr Mary Ellen Valletta |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 2010 N Young Blvd, Chiefland, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1275573487 | NPI | - | NPPES |
270589300 | Medicaid | FL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | ME90984 (Florida) | Primary |
Entity Name | Florida Clinical Practice Association Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1063463768 PECOS PAC ID: 0345146254 Enrollment ID: O20031211000099 |
Entity Name | Trenton Medical Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1801826268 PECOS PAC ID: 2365359387 Enrollment ID: O20050428000865 |
Mailing Address | Practice Location Address |
---|---|
Dr Mary Ellen Valletta, MD 911 S Main St, Trenton, FL 32693-3239 Ph: (352) 463-2374 | Dr Mary Ellen Valletta, MD 2010 N Young Blvd, Chiefland, FL 32626-1951 Ph: (352) 463-2374 |
Dr. Valerie C Burns, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 410 N Main St, Ste 1-2, Chiefland, FL 32626 Phone: 352-493-7274 Fax: 352-493-9290 | |
Dr. Mervin Punzalan Manuel, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 410 N Main St Ste 1-2, Chiefland, FL 32626 Phone: 352-493-7274 Fax: 352-493-9290 |