Provider Demographics
NPI:1063628725
Name:VELAZQUEZ CARRION, ROSA N (RPT, CWS)
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:N
Last Name:VELAZQUEZ CARRION
Suffix:
Gender:F
Credentials:RPT, CWS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 GIRARD DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-5266
Mailing Address - Country:US
Mailing Address - Phone:407-709-3487
Mailing Address - Fax:407-933-0177
Practice Address - Street 1:1012 EMMETT ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5415
Practice Address - Country:US
Practice Address - Phone:407-933-0891
Practice Address - Fax:407-933-0177
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT6084225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist