MEDICARE: DR. THOMAS KARL VELLEFF JR. 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	207QB0002X	Obesity Medicine (Family Medicine) Physician	ME42998	FL
2	208D00000X	General Practice Physician	ME42998	FL
3	208VP0000X	Pain Medicine Physician	ME42998	FL

General Provider Information

NPI Number	:	1558388454
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS KARL VELLEFF JR. M. D.

Provider Business Mailing Address
First Line	:	3150 N WICKHAM RD
Second Line	:	SUITE 9
City	:	MELBOURNE
State	:	FL
Zip	:	32935-2322
Country	:	US
Telephone Number	:	321-241-6441
Fax Number	:	321-241-6443

Provider Business Practice Location Address
First Line	:	3150 N WICKHAM RD
Second Line	:	SUITE 9
City	:	MELBOURNE
State	:	FL
Zip	:	32935-2322
Country	:	US
Telephone Number	:	321-241-6441
Fax Number	:	321-241-6443

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

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	09/30/2019

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