Valencia, Mario
Valencia, Mario is an sole proprietor health care provider with primary practice located at 2829 4Th Ave Ste 150 , Lake Charles LA 70601-7897. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Valencia, Mario can be contacted via phone (337) 480-7800.Contact Information
Primary practice address
2829 4Th Ave Ste 150
Lake Charles LA 70601-7897
Phone: (337) 480-7800
Fax: (337) 474-4552
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | TRN 20218 | Florida |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | ME130637 | Florida |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 309286 | Louisiana |
Profile Details
| NPI number | 1548623515 |
|---|---|
| LBN Legal business name | Valencia, Mario |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 29th, 2016 |
| Last updated | May 12th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548623515 | NPPES |
| Louisiana | MEDICAID | 2476572 |
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