Provider Demographics
NPI:1518190834
Name:ACOSTA VELEZ, MARTA I (OD)
Entity Type:Individual
Prefix:DR
First Name:MARTA
Middle Name:I
Last Name:ACOSTA VELEZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1881 79TH STREET CSWY
Mailing Address - Street 2:APT 2006
Mailing Address - City:NORTH BAY VILLAGE
Mailing Address - State:FL
Mailing Address - Zip Code:33141-4277
Mailing Address - Country:US
Mailing Address - Phone:939-639-6250
Mailing Address - Fax:305-675-0443
Practice Address - Street 1:7330 OCEAN TER
Practice Address - Street 2:SUITE 2003
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33141-2722
Practice Address - Country:US
Practice Address - Phone:939-639-6250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-02
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4496152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist