Provider Demographics
NPI:1164689311
Name:ALQUIZAR, PEDRO JULIO (DMD, MMSC)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:JULIO
Last Name:ALQUIZAR
Suffix:
Gender:M
Credentials:DMD, MMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2461 W 76TH ST APT 101
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5672
Mailing Address - Country:US
Mailing Address - Phone:305-975-2405
Mailing Address - Fax:
Practice Address - Street 1:2645 S DOUGLAS RD
Practice Address - Street 2:SUITE 703
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2754
Practice Address - Country:US
Practice Address - Phone:305-448-3228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN175121223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics