Healthcare Provider Details

I. General information

NPI: 1447166210
Provider Name (Legal Business Name): VICTORIA BOTELHO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1560 LENOX AVE STE 201
MIAMI BEACH FL
33139-3388
US

IV. Provider business mailing address

2751 N PALM AIRE DR APT 406
POMPANO BEACH FL
33069-3413
US

V. Phone/Fax

Practice location:
  • Phone: 786-502-1818
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: