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General NPI Number Information
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NPI Number | 1528851912
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Entity Type | Individual
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Provider Name | LEO VELASCO II PT
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Gender | Male
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 5381 DESOTO RD
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City | SARASOTA
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State | FL
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Zip | 34235-2618
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Country | US
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Telephone | 941-355-6111
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Fax |
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Provider Business Mailing Address
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Address Line | 6110 MAIDENSTONE WAY
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City | PALMETTO
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State | FL
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Zip | 34221-2282
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Country | US
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Telephone | 443-762-4355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 38144
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License Number State | FL
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