Provider Demographics
NPI:1275078016
Name:VELASCO VALIDO, EDUARDO (AP)
Entity Type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:
Last Name:VELASCO VALIDO
Suffix:
Gender:M
Credentials:AP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E BROWARD BLVD STE 403
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33301-2033
Mailing Address - Country:US
Mailing Address - Phone:503-575-0568
Mailing Address - Fax:
Practice Address - Street 1:800 E BROWARD BLVD STE 403
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33301-2033
Practice Address - Country:US
Practice Address - Phone:718-986-3079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP4321171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist