MEDICARE: VALENTINA VELASQUEZ DPT, PT

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	225100000X	Physical Therapist	PT016805	GA

General Provider Information

NPI Number	:	1225813777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALENTINA VELASQUEZ DPT, PT

Provider Business Mailing Address
First Line	:	892 E PONCE DE LEON AVE
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-2037
Country	:	US
Telephone Number	:	954-849-7339
Fax Number	:

Provider Business Practice Location Address
First Line	:	495 WINN WAY STE 250
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30030-1751
Country	:	US
Telephone Number	:	404-294-1313
Fax Number	:

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

Provider Enumeration Date	:	08/31/2023
Last Update Date	:	08/31/2023

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Directions to “ VALENTINA VELASQUEZ DPT, PT” Practice Location

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