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General NPI Number Information
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NPI Number | 1063946887
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Entity Type | Individual
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Provider Name | INGRID VICTORIA QUIROZ MEJIA SA-C
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Gender | Female
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 10155 NW 9TH STREET CIR APT 405
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City | MIAMI
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State | FL
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Zip | 33172-6620
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Country | US
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Telephone | 786-818-2380
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Fax |
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Provider Business Mailing Address
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Address Line | 10155 NW 9TH STREET CIR APT 405
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City | MIAMI
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State | FL
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Zip | 33172-6620
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Country | US
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Telephone | 786-818-2380
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 17-218
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License Number State | FL
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