Provider Demographics
NPI:1497812770
Name:ANGEL VELOSO MD PA
Entity Type:Organization
Organization Name:ANGEL VELOSO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VELOSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-262-6060
Mailing Address - Street 1:7500 SW 8TH ST
Mailing Address - Street 2:SUITE 309
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-4400
Mailing Address - Country:US
Mailing Address - Phone:305-262-6060
Mailing Address - Fax:305-262-6038
Practice Address - Street 1:7500 SW 8TH ST
Practice Address - Street 2:SUITE 309
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4400
Practice Address - Country:US
Practice Address - Phone:305-262-6060
Practice Address - Fax:305-262-6038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME39123207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8019Medicare ID - Type Unspecified
FLD63607Medicare UPIN