MEDICARE: DR. JENNY THERESA VELEZ M.D.

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	208000000X	Pediatrics Physician	ME69983	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437156502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNY THERESA VELEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 191
Second Line	:
City	:	ROCKLAND
State	:	DE
Zip	:	19732-0191
Country	:	US
Telephone Number	:	302-651-4488
Fax Number	:	302-651-4945

Provider Business Practice Location Address
First Line	:	5018 DR PHILLIPS BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-3310
Country	:	US
Telephone Number	:	407-363-5753
Fax Number	:	407-351-4121

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	02/14/2014

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