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General NPI Number Information
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NPI Number | 1669759270
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA PRIMARY PHYSICIANS
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 09/30/2015
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Provider Practice Location Address
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Address Line | 8865 COMMODITY CIR STE 7
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City | ORLANDO
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State | FL
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Zip | 32819-9077
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Country | US
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Telephone | 407-720-3523
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Fax | 407-720-3524
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Provider Business Mailing Address
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Address Line | 1565 SAXON BLVD STE 103
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City | DELTONA
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State | FL
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Zip | 32725-5876
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Country | US
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Telephone | 386-574-1423
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Fax | 386-860-9239
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Authorized Official
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Title or Position | OWNER
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Name | MR. ANDRES F VELASCO
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Credential | MD
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Telephone | 386-574-1423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME96936
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License Number State | FL
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