Provider Demographics
NPI:1205837101
Name:VASILIU-FELTES, INGRID (MD)
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:VASILIU-FELTES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:INGRID
Other - Middle Name:
Other - Last Name:VASILIU-FELTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1400 NW 10TH AVE STE 301D
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33136-1000
Mailing Address - Country:US
Mailing Address - Phone:305-243-9950
Mailing Address - Fax:305-243-4061
Practice Address - Street 1:1400 NW 10TH AVE STE 301D
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-1000
Practice Address - Country:US
Practice Address - Phone:305-243-9950
Practice Address - Fax:305-243-4061
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1007712084P0800X
FLME 1007712084P0804X
AL247852084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL24785OtherAL LICENSE
FLME 100771OtherFLORIDA LICENSE
ALBV8273435OtherDEA
ALH89533Medicare UPIN