Healthcare Provider Details

I. General information

NPI: 1124861968
Provider Name (Legal Business Name): DR VELASCO CONCIERGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2024
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3790 7TH TER STE 102
VERO BEACH FL
32960-6552
US

IV. Provider business mailing address

3790 7TH TER STE 102
VERO BEACH FL
32960-6552
US

V. Phone/Fax

Practice location:
  • Phone: 772-362-9283
  • Fax: 772-362-9280
Mailing address:
  • Phone: 772-362-9283
  • Fax: 772-362-9280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RODRIGO ERNESTO VELASCO
Title or Position: OWNER
Credential:
Phone: 786-385-0175