MEDICARE: LORENA VELAZQUEZ GARCIA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-23-310495	FL

General Provider Information

NPI Number	:	1093580292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORENA VELAZQUEZ GARCIA

Provider Business Mailing Address
First Line	:	2181 16TH AVE SW
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34117-4338
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2181 16TH AVE SW
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34117-4338
Country	:	US
Telephone Number	:	954-654-2473
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/17/2023
Last Update Date	:	05/14/2025

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