Individual
GLORIA C MONDRAGON VELEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2730 UNIVERSITY BLVD W STE 1010, SILVER SPRING, MD 20902-5902
(240) 752-8822
(240) 752-8821
Mailing address
510 NW 84 AVE APT 539, PLANTATION, FL 33324-2120
(786) 515-5772
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN21573
FL
1223P0221X
Pediatric Dentistry
Primary
17173
MD
1223P0221X
Pediatric Dentistry
DN21573
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN21573
FLORIDA DEPARTMENT OF HEALTH MQA
FL
Enumeration date
01/07/2016
Last updated
03/06/2020
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