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NPI Code Detail

MEDICARE: MR. CARLOS VELAZQUEZ III LCSW

MEDICARE: MR. CARLOS VELAZQUEZ III LCSW
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
11041C0700XClinical Social WorkerSW10661FL
21041C0700XClinical Social Worker13332528-3501UT

General Provider Information

NPI Number : 1427384320
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CARLOS VELAZQUEZ III LCSW
Provider Business Mailing Address
First Line : 8376 CORKFIELD AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32832-5009
Country : US
Telephone Number : 407-928-4692
Fax Number :
Provider Business Practice Location Address
First Line : 8376 CORKFIELD AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32832-5009
Country : US
Telephone Number : 407-928-4692
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2009
Last Update Date : 03/17/2026

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