Provider Demographics
NPI:1528190162
Name:DELGADO-VELASQUEZ, NORA ELENA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NORA
Middle Name:ELENA
Last Name:DELGADO-VELASQUEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13805 SPRINGER LN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33625-4143
Mailing Address - Country:US
Mailing Address - Phone:813-383-9729
Mailing Address - Fax:
Practice Address - Street 1:3333 W KENNEDY BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2976
Practice Address - Country:US
Practice Address - Phone:813-879-2969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00125361223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics