MEDICARE: DR. MARUJA SANTIAGO VELEZ MD

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	2085N0700X	Neuroradiology Physician	ME82573	FL
2	2085U0001X	Diagnostic Ultrasound Physician	ME82573	FL
3	2085R0202X	Diagnostic Radiology Physician	ME82573	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	06304	OTHER	FL	BLUE CROSS BLUE SHILED

General Provider Information

NPI Number	:	1831135367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARUJA SANTIAGO VELEZ MD

Provider Business Mailing Address
First Line	:	5111 CHEROKEE AVE
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2624
Country	:	US
Telephone Number	:	305-866-8852
Fax Number	:	350-722-3634

Provider Business Practice Location Address
First Line	:	5111 CHEROKEE AVE
Second Line	:
City	:	MIAMI BEACH
State	:	FL
Zip	:	33140-2624
Country	:	US
Telephone Number	:	305-866-8852
Fax Number	:	350-722-3634

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	06/09/2020

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