Provider Demographics
NPI:1366979270
Name:NARVAEZ DE V, VERONICA CECILIA
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:CECILIA
Last Name:NARVAEZ DE V
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 SW 159TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33027-4836
Mailing Address - Country:US
Mailing Address - Phone:786-285-1648
Mailing Address - Fax:
Practice Address - Street 1:4025 SW 159TH AVE
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-4836
Practice Address - Country:US
Practice Address - Phone:786-285-1648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN225391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice