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Eduardo
Eduardo
Celis valdiviezo
Medical doctor
Lutz, United States
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Florida Health Care Practitioner Data Portal
Full name
Eduardo Celis Valdiviezo
Job Title
Medical Doctor
Location
Lutz, FL, USA
LIC ID
149192
Current License Expiration Date
31/01/2026
Original Date
21/07/2020
Professional Rank Code
ME
Effective Date
21/07/2020
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
HILLSBOROUGH
Practice Location Address Line 1
12902 USF Magnolia Dr
Practice Location Address Line 2
CSB 1162
Practice Location Address City
TAMPA
Practice Location Address State
FL
Practice Location Address Zipcode
33612-4799
Prescribing Indicator
Y
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