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General NPI Number Information
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NPI Number | 1285681999
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Entity Type | Individual
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Provider Name | MARIA DEFATIMA POZUELO MD
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Gender | Female
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Dates
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Enumeration Date | 05/28/2006
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 1651 SE TIFFANY AVE
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34952-7564
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Country | US
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Telephone | 772-223-4978
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Fax | 772-345-1815
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Provider Business Mailing Address
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Address Line | 1651 SE TIFFANY AVE
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City | PORT ST LUCIE
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State | FL
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Zip | 34952-7564
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Country | US
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Telephone | 772-226-4978
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Fax | 772-945-1815
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 35072078
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | ME155490
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License Number State | FL
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