Healthcare Provider Details

I. General information

NPI: 1295077832
Provider Name (Legal Business Name): ROBERT VELARDE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2013
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4850 SW 91ST TERRACE APT 302
GAINESVILLE FL
32608-6037
US

IV. Provider business mailing address

4715 MERWIN ST
HOUSTON TX
77027-6607
US

V. Phone/Fax

Practice location:
  • Phone: 323-762-3742
  • Fax:
Mailing address:
  • Phone: 713-562-6514
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberQ6380
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME145312
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: