MEDICARE: DR. ANDREW JOSEPH VELAZQUEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	23838	AL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00035987	OTHER	AL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	H62765	OTHER	AL	HEALTHSPRING OF ALABAMA
4	051514650	OTHER	AL	BLUE CROSS
5	925494	OTHER	AL	BLOCK VISION

General Provider Information

NPI Number	:	1013930825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW JOSEPH VELAZQUEZ MD

Provider Business Mailing Address
First Line	:	3928 MONTCLAIR RD STE 100
Second Line	:
City	:	MOUNTAIN BRK
State	:	AL
Zip	:	35213-2415
Country	:	US
Telephone Number	:	205-592-3911
Fax Number	:	205-592-3537

Provider Business Practice Location Address
First Line	:	3928 MONTCLAIR RD STE 100
Second Line	:
City	:	MOUNTAIN BRK
State	:	AL
Zip	:	35213-2415
Country	:	US
Telephone Number	:	205-592-3911
Fax Number	:	205-592-3537

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	06/24/2021

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Directions to “ DR. ANDREW JOSEPH VELAZQUEZ MD” Practice Location

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