Provider Demographics
NPI:1356634281
Name:VELEZ, CARMEN G (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:G
Last Name:VELEZ
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 616788
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32861-6788
Mailing Address - Country:US
Mailing Address - Phone:407-253-3537
Mailing Address - Fax:407-770-0661
Practice Address - Street 1:911 N CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-5029
Practice Address - Country:US
Practice Address - Phone:407-933-2690
Practice Address - Fax:407-933-4422
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2014-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA11582363L00000X
FL9333865363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP9333865OtherFL STATE LICENSE