MEDICARE: MRS. STELLA I VELEZ MA, ITDS, CFLE

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	252Y00000X	Early Intervention Provider Agency
2	222Q00000X	Developmental Therapist

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

General Provider Information

NPI Number	:	1902022098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STELLA I VELEZ MA, ITDS, CFLE

Provider Business Mailing Address
First Line	:	15780 78TH DR N
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-1856
Country	:	US
Telephone Number	:	561-746-2110
Fax Number	:	772-409-8694

Provider Business Practice Location Address
First Line	:	15780 78TH DR N
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-1856
Country	:	US
Telephone Number	:	561-746-2110
Fax Number	:	772-409-8694

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

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	10/22/2014

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