Provider Demographics
NPI:1245336650
Name:NUMSSEN, VALERIE (MD)
Entity type:Individual
Prefix:DR
First Name:VALERIE
Middle Name:
Last Name:NUMSSEN
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 1:1131 NW 64TH TER
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4228
Mailing Address - Country:US
Mailing Address - Phone:352-332-9940
Mailing Address - Fax:352-332-9939
Practice Address - Street 1:1131 NW 64TH TER
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4228
Practice Address - Country:US
Practice Address - Phone:352-332-9940
Practice Address - Fax:352-332-9939
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME78807208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
51603OtherBCBS
593537428OtherPHCS
593537428OtherPCN
FL259344100Medicaid
3703438001OtherCIGNA
7120237OtherAETNA
593537428OtherFIRST HEALTH
277238OtherAVMED
593537428OtherUNITED HEALTHCARE
593537428OtherCHAMPUS/TRICARE
070482OtherVISTA HEALTHPLAN
593537428OtherPEDICARE
593537428OtherFIRST HEALTH