MEDICARE: ERIKA PABLOS-VELEZ PSY.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	103T00000X	Psychologist	PY8672	FL

General Provider Information

NPI Number	:	1831437334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIKA PABLOS-VELEZ PSY.D.

Provider Business Mailing Address
First Line	:	9347 NW 114TH LN
Second Line	:
City	:	HIALEAH GARDENS
State	:	FL
Zip	:	33018-4269
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4175 W 20TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33012-5874
Country	:	US
Telephone Number	:	305-825-0300
Fax Number	:

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

Provider Enumeration Date	:	01/18/2013
Last Update Date	:	01/18/2013

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