Provider Demographics
NPI:1477903987
Name:VELASQUEZ, NATHALIA (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHALIA
Middle Name:
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NATHALIA
Other - Middle Name:
Other - Last Name:GARCIA-LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:204 NW 134TH TER UNIT 25-103
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33325-7658
Mailing Address - Country:US
Mailing Address - Phone:650-400-2649
Mailing Address - Fax:
Practice Address - Street 1:2950 CLEVELAND CLINIC BLVD BLDG A
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3625
Practice Address - Country:US
Practice Address - Phone:954-659-5786
Practice Address - Fax:954-659-5787
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA87520207YX0602X
FLME156237207YX0602X, 207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy