Provider Demographics
NPI:1871786970
Name:BEDARD, VALERIE (MD)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:
Last Name:BEDARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 PALMA DE SIERRA
Mailing Address - Street 2:URB BOSQUE SENORIAL
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728
Mailing Address - Country:US
Mailing Address - Phone:787-812-2200
Mailing Address - Fax:787-843-1516
Practice Address - Street 1:909 AVE TITO CASTRO STE 610
Practice Address - Street 2:TORRE MEDICA SAN LUCAS
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4721
Practice Address - Country:US
Practice Address - Phone:787-812-2200
Practice Address - Fax:787-843-1516
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17413207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRDN275AMedicare PIN