Provider Demographics
NPI:1184640096
Name:VELIZ, ARMANDO ERICH (PA)
Entity Type:Individual
Prefix:MR
First Name:ARMANDO
Middle Name:ERICH
Last Name:VELIZ
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2228 SLOANE PLACE
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414
Mailing Address - Country:US
Mailing Address - Phone:954-937-4974
Mailing Address - Fax:
Practice Address - Street 1:3800 S OCEAN DR STE 209
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33019-2915
Practice Address - Country:US
Practice Address - Phone:305-466-9988
Practice Address - Fax:305-466-9989
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9101387363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0010-05349OtherMEDICAL LICENSE
FLPA9101387OtherMEDICAL LICENSE