Provider Demographics
NPI:1114409612
Name:VELA, NORY MEDALITH (MS, SLP)
Entity Type:Individual
Prefix:MRS
First Name:NORY
Middle Name:MEDALITH
Last Name:VELA
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:MS
Other - First Name:NORY
Other - Middle Name:M
Other - Last Name:VILA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4295 W VISTA CT
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34746-4038
Mailing Address - Country:US
Mailing Address - Phone:267-254-2053
Mailing Address - Fax:
Practice Address - Street 1:11602 LAKE UNDERHILL RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4458
Practice Address - Country:US
Practice Address - Phone:407-277-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ8767235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist