MEDICARE: LINDA VELEZ LMHC

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	101YM0800X	Mental Health Counselor	MH10098	FL

General Provider Information

NPI Number	:	1134443278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA VELEZ LMHC

Provider Business Mailing Address
First Line	:	3152 LITTLE RD
Second Line	:	SUITE 169
City	:	TRINITY
State	:	FL
Zip	:	34655-1864
Country	:	US
Telephone Number	:	727-753-9084
Fax Number	:	727-202-9033

Provider Business Practice Location Address
First Line	:	8042 OLD COUNTY ROAD 54
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-6457
Country	:	US
Telephone Number	:	727-753-9084
Fax Number	:	727-202-9033

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

Provider Enumeration Date	:	03/18/2010
Last Update Date	:	05/27/2015

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