Healthcare Provider Details

I. General information

NPI: 1154709376
Provider Name (Legal Business Name): BRENDA VELEZ M. ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2015
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6757 KALAMBA ST
ORLANDO FL
32807-5057
US

IV. Provider business mailing address

6757 KALAMBA ST
ORLANDO FL
32807-5057
US

V. Phone/Fax

Practice location:
  • Phone: 407-431-8841
  • Fax:
Mailing address:
  • Phone: 407-431-8841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH20505
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: