Healthcare Provider Details

I. General information

NPI: 1457275869
Provider Name (Legal Business Name): VELA SMILE STUDIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 39TH ST W
BRADENTON FL
34205-2454
US

IV. Provider business mailing address

201 4TH ST S UNIT 322
ST PETERSBURG FL
33701-4564
US

V. Phone/Fax

Practice location:
  • Phone: 754-610-8595
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. PABLO VELAZQUEZ
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 754-610-8595