Healthcare Provider Details

I. General information

NPI: 1790706208
Provider Name (Legal Business Name): FABIO VELEZ ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 NW 12TH AVE
MIAMI FL
33136-1005
US

IV. Provider business mailing address

11737 NW 39TH ST
SUNRISE FL
33323-2632
US

V. Phone/Fax

Practice location:
  • Phone: 305-585-1872
  • Fax: 305-326-7065
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number3232822
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: