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General NPI Number Information
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NPI Number | 1972901064
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Entity Type | Organization
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Legal Business Name | VELEZ FAMILY HEALTH, LLC
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Dates
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Enumeration Date | 12/05/2014
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Last Update Date | 12/05/2014
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Provider Practice Location Address
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Address Line | 7575 DR PHILLIPS BLVD STE 120
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City | ORLANDO
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State | FL
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Zip | 32819-7221
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Country | US
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Telephone | 407-530-6591
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Fax | 855-817-7755
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Provider Business Mailing Address
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Address Line | 7575 DR PHILLIPS BLVD STE 120
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City | ORLANDO
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State | FL
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Zip | 32819-7221
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Country | US
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Telephone | 407-530-6591
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Fax | 855-817-7755
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Authorized Official
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Title or Position | MANAGER
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Name | TANIA VELEZ
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Credential | MD
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Telephone | 321-356-6864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME111142
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License Number State | FL
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