MEDICARE: OCTAVIO JUAN PEREZ-VELASCO 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	207Q00000X	Family Medicine Physician	ME81174	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00027558	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51903	OTHER	FL	BCBS
2	5495696	OTHER	FL	AETNA
4	ME81174	OTHER	FL	MEDICAL LICENSE
5	10636201	OTHER	FL	CITRUS
6	5903996	OTHER	FL	GHI
7	37439	OTHER	FL	AMERIGROUP

General Provider Information

NPI Number	:	1205809233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OCTAVIO JUAN PEREZ-VELASCO MD

Provider Business Mailing Address
First Line	:	1312 W FLETCHER AVE
Second Line	:	SUITE A
City	:	TAMPA
State	:	FL
Zip	:	33612-3366
Country	:	US
Telephone Number	:	813-964-0595
Fax Number	:	813-963-5071

Provider Business Practice Location Address
First Line	:	8326 N FLORIDA AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-3006
Country	:	US
Telephone Number	:	656-207-7275
Fax Number	:	813-559-6454

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	03/25/2026

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Directions to “ OCTAVIO JUAN PEREZ-VELASCO MD” Practice Location

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