Organization
HIALEAH DERMATOLOGY AND COSMETIC CENTER LLC
Active
Organization
HIALEAH DERMATOLOGY AND COSMETIC CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NELSON EDDIE VELAZQUEZ DO (PRESIDENT)
(305) 822-0678
Entity
Organization
Contact information
Practice address
7000 W 12TH AVE, SUITE#4, HIALEAH, FL 33014-5154
(305) 822-0678
(305) 822-0698
Mailing address
7000 W 12TH AVE, SUITE#4, HIALEAH, FL 33014-5154
(305) 822-0678
(305) 822-0698
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
OS6127
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
600471-7
OCCUPATIONAL LICENSE
FL
01
—
OS6127
MEDICAL LICENSE NUMBER
FL
Enumeration date
10/12/2006
Last updated
03/07/2023
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