Provider Demographics
NPI:1780391086
Name:FELIX AMEZQUITA, MARIA VICTORIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:VICTORIA
Last Name:FELIX AMEZQUITA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:788 E 182ND ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-1154
Mailing Address - Country:US
Mailing Address - Phone:917-651-7501
Mailing Address - Fax:
Practice Address - Street 1:788 E 182ND ST APT 2B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-1154
Practice Address - Country:US
Practice Address - Phone:917-651-7501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator