Healthcare Provider Details

I. General information

NPI: 1912132994
Provider Name (Legal Business Name): MICHAEL VELTRE DPM, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2009
Last Update Date: 05/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11389 W FLAGLER ST
MIAMI FL
33174-1185
US

IV. Provider business mailing address

11389 W FLAGLER ST
MIAMI FL
33174-1185
US

V. Phone/Fax

Practice location:
  • Phone: 305-480-2045
  • Fax: 305-480-2046
Mailing address:
  • Phone: 305-480-2045
  • Fax: 305-480-2046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License NumberPO3121
License Number StateFL

VIII. Authorized Official

Name: MICHAEL VELTRE
Title or Position: PRESIDENT
Credential:
Phone: 786-282-9181