Provider Demographics
NPI:1407050149
Name:MEJIA FELIPE, VERONICA M (DMD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:M
Last Name:MEJIA FELIPE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1053 SW 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33129-2713
Mailing Address - Country:US
Mailing Address - Phone:305-794-7324
Mailing Address - Fax:
Practice Address - Street 1:3333 W 4TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-4360
Practice Address - Country:US
Practice Address - Phone:305-556-3512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN155521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice