MEDICARE: DR. JOSE L VELAZQUEZ 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	207L00000X	Anesthesiology Physician	ME21041	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	051907247	OTHER	FL	RAILROAD MEDICARE PROVIDER NUMBER

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	52866	OTHER	FL	BCBS OF FLORIDA

General Provider Information

NPI Number	:	1851399851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE L VELAZQUEZ M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1074
Second Line	:	C/O ANESTHESIA ASSOCIATES OF DUNEDIN
City	:	DUNEDIN
State	:	FL
Zip	:	34697-1074
Country	:	US
Telephone Number	:	727-734-6932
Fax Number	:	727-734-4516

Provider Business Practice Location Address
First Line	:	646 VIRGINIA ST
Second Line	:	4TH FLOOR
City	:	DUNEDIN
State	:	FL
Zip	:	34698-6612
Country	:	US
Telephone Number	:	727-734-6932
Fax Number	:	727-734-4516

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

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	06/17/2008

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Directions to “ DR. JOSE L VELAZQUEZ M.D.” Practice Location

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