Provider Demographics
NPI:1194228635
Name:VELEZ, EMILIO JR (MA)
Entity Type:Individual
Prefix:
First Name:EMILIO
Middle Name:
Last Name:VELEZ
Suffix:JR
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 N 13TH SQ
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-2101
Mailing Address - Country:US
Mailing Address - Phone:646-271-4376
Mailing Address - Fax:
Practice Address - Street 1:1302 N LAWNWOOD CIR
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4806
Practice Address - Country:US
Practice Address - Phone:772-468-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor