Healthcare Provider Details

I. General information

NPI: 1235357807
Provider Name (Legal Business Name): MARITES HIDALGO VELASQUEZ ARNP,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 10/24/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13005 SOUTHERN BLVD STE 121
LOXAHATCHEE FL
33470-9231
US

IV. Provider business mailing address

7593 W BOYNTON BEACH BLVD STE 220
BOYNTON BEACH FL
33437-6162
US

V. Phone/Fax

Practice location:
  • Phone: 561-444-3887
  • Fax:
Mailing address:
  • Phone: 561-649-7000
  • Fax: 888-316-2198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9167692
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: