Provider Demographics
NPI:1629325592
Name:DIGGLE, YENEIR URQUIZA (DMD)
Entity type:Individual
Prefix:DR
First Name:YENEIR
Middle Name:URQUIZA
Last Name:DIGGLE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:YENEIR
Other - Middle Name:
Other - Last Name:URQUIZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:700 SE BECKER RD # 101
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34984-6621
Mailing Address - Country:US
Mailing Address - Phone:786-301-5629
Mailing Address - Fax:
Practice Address - Street 1:4000 ATLANTIC BLVD STE 101
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-2479
Practice Address - Country:US
Practice Address - Phone:772-567-2132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-10
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN198061223G0001X
FLDN 198061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice