Individual
MARIANA VELAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
8700 N KENDALL DR, SUITE #221, MIAMI, FL 33176-2206
(305) 595-4122
Mailing address
8700 N KENDALL DR, SUITE #221, MIAMI, FL 33176-2206
(305) 595-4122
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN20923
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DN20923
DENTAL LICENSE
FL
Enumeration date
07/13/2008
Last updated
05/06/2015
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