Provider Demographics
NPI:1427384320
Name:VELAZQUEZ, CARLOS III (LCSW)
Entity Type:Individual
Prefix:MR
First Name:CARLOS
Middle Name:
Last Name:VELAZQUEZ
Suffix:III
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8376 CORKFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-5009
Mailing Address - Country:US
Mailing Address - Phone:407-928-4692
Mailing Address - Fax:
Practice Address - Street 1:8376 CORKFIELD AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-5009
Practice Address - Country:US
Practice Address - Phone:407-928-4692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW106611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical