Provider Demographics
NPI:1508324237
Name:VELEZ MEJIA, BEATRIZ E (LMT)
Entity Type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:E
Last Name:VELEZ MEJIA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 NE 22ND ST APT 1206
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-5186
Mailing Address - Country:US
Mailing Address - Phone:786-216-3265
Mailing Address - Fax:
Practice Address - Street 1:7920 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-4209
Practice Address - Country:US
Practice Address - Phone:305-261-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA76655225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty