| Ruben B Vallejo Md Pa | |
|
1777 S Andrews Ave Suite 201 Ft Lauderdale FL 33316-2517 | |
| (954) 581-4111 | |
| Not Available |
| Full Name | Ruben B Vallejo Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1777 S Andrews Ave, Ft Lauderdale, Florida |
| Authorized Official Name and Position | Ruben Vallejo (PRESIDENT) |
| Authorized Official Contact | 9545814111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ruben B Vallejo Md Pa Po Box 19708 Plantation FL 33318-0708 Ph: () - | Ruben B Vallejo Md Pa 1777 S Andrews Ave Suite 201 Ft Lauderdale FL 33316-2517 Ph: (954) 581-4111 |
| NPI Number | 1710266754 |
|---|---|
| Provider Enumeration Date | 08/09/2011 |
| Last Update Date | 11/28/2016 |
| Medicare PECOS PAC ID | 8426227323 |
|---|---|
| Medicare Enrollment ID | O20110810000578 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710266754 | NPI | - | NPPES |
| 038592100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Ruben B Vallejo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841345873 PECOS PAC ID: 3577732353 Enrollment ID: I20110818000117 |
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