Juan Velasco
Dentist in Oakland Park, FL. Individual provider (NPI-1).
NPI number1013376144
StatusActive
Last updated in NPPESFeb 17, 2016
Details
- NPI
- 1013376144
- Entity type
- Individual (NPI-1)
- Name
- Juan Velasco
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 17, 2016
- Last updated
- Feb 17, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | Teaching Permit 611 | FL | Yes |
Practice location
830 E Oakland Park BlvdOakland Park, FL 33334-2761
Phone 954-262-7530
Mailing address
830 E Oakland Park BlvdOakland Park, FL 33334-2761
Phone 954-262-7530
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