MEDICARE: C & M PHYSICIANS LLC

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	208D00000X	General Practice Physician		FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	VELA0774	OTHER	FL	COMM INSURANCES

General Provider Information

NPI Number	:	1063852218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C & M PHYSICIANS LLC

Provider Business Mailing Address
First Line	:	7532 SW 122ND CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-3634
Country	:	US
Telephone Number	:	718-600-2358
Fax Number	:	786-431-5880

Provider Business Practice Location Address
First Line	:	7532 SW 122ND CT
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-3634
Country	:	US
Telephone Number	:	718-600-2358
Fax Number	:	786-431-5880

Authorized Official
Title or Position	:	OWNER
Name	:	JUAN M VELAZQUEZ
Credential	:	MD
Telephone Number	:	718-600-2358

Provider Enumeration Date	:	07/02/2013
Last Update Date	:	07/02/2013

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Directions to “C & M PHYSICIANS LLC ” Practice Location

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