Provider Demographics
NPI:1235357807
Name:VELASQUEZ, MARITES HIDALGO (ARNP,BC)
Entity Type:Individual
Prefix:MRS
First Name:MARITES
Middle Name:HIDALGO
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:ARNP,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 LAKE WORTH RD
Mailing Address - Street 2:STE 204
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-3213
Mailing Address - Country:US
Mailing Address - Phone:561-966-7717
Mailing Address - Fax:888-316-2198
Practice Address - Street 1:13005 SOUTHERN BLVD STE 121
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-9231
Practice Address - Country:US
Practice Address - Phone:561-444-3887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9167692363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily