Johanna C Fuentes-Valdes, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME153583 Issued in FL

Practice address

2748 Windguard Cir Ste 102
Wesley Chapel, FL 33544-7364

Phone

(813) 461-4428

Fax

(813) 291-7397

NPI assigned

Jul 16, 2006

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other names 1

• Johanna C Fuentes-Daza Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2022 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jfuentesvaldes364383@hisp.ehr.sutterhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Valdes

  • Clinic/Center
  • Lehi, UT
  • NPI 1093169872
  NPD (past)
• Valdes, PC

  • Internal Medicine Physician
  • Lehi, UT
  • NPI 1003273418
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1184641987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2748 WINDGUARD CIR STE 102",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335447364",
            "telephone_number": "813-461-4428",
            "fax_number": "813-291-7397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2748 WINDGUARD CIR STE 102",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335447364",
            "telephone_number": "813-461-4428",
            "fax_number": "813-291-7397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES-VALDES",
        "first_name": "JOHANNA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-16",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "8471315-1205",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "C137378",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME153583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOHANNA",
            "last_name": "FUENTES-DAZA",
            "middle_name": "C",
            "credential": "M.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William French
• Gretta Fridman, MD
• Samantha Samataro Frisone, LMFT
• Robert John Fry, CRNA
• FSBS Enterprises, Inc.
• Kathryn Fultz
• Functionality for Life, LLC
• Justine Marie Gabel, LMHC
• Randa Gad Elrab
• Brooke Galiszewski

• Internal Medicine Physician in Wesley Chapel, FL
• Providers in Wesley Chapel, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.