Healthcare Provider Details

I. General information

NPI: 1255206363
Provider Name (Legal Business Name): NATHALIE VEIZAGA MT-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 11/16/2025
Certification Date: 11/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 PLUNKETT ST
HOLLYWOOD FL
33020-6350
US

IV. Provider business mailing address

1920 PLUNKETT ST
HOLLYWOOD FL
33020-6350
US

V. Phone/Fax

Practice location:
  • Phone: 786-420-8306
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number18049
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: