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NPI Code Detail

MEDICARE: YARELIS REYES VELAZQUEZ MD

MEDICARE:   YARELIS  REYES VELAZQUEZ  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
1390200000XStudent in an Organized Health Care Education/Training Program
2207Q00000XFamily Medicine PhysicianME143862FL

Other Identifiers

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

General Provider Information

NPI Number : 1770017428
Entity Type Code : Individual
Provider Name (Legal Business Name) : YARELIS REYES VELAZQUEZ MD
Provider Business Mailing Address
First Line : 1801 NW 9TH AVE
Second Line : SUITE 470
City : MIAMI
State : FL
Zip : 33136-1101
Country : US
Telephone Number : 305-243-1245
Fax Number :
Provider Business Practice Location Address
First Line : 16555 NW 25TH AVE
Second Line :
City : MIAMI GARDENS
State : FL
Zip : 33054-6583
Country : US
Telephone Number : 786-466-1900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2017
Last Update Date : 08/18/2020

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Directions to “ YARELIS REYES VELAZQUEZ MD” Practice Location

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