Provider Demographics
NPI:1558943373
Name:VELEZ, GLENDALIZ
Entity Type:Individual
Prefix:
First Name:GLENDALIZ
Middle Name:
Last Name:VELEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 WESTON LN APT H
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-4440
Mailing Address - Country:US
Mailing Address - Phone:321-666-1558
Mailing Address - Fax:
Practice Address - Street 1:2215 WESTON LN APT H
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-4440
Practice Address - Country:US
Practice Address - Phone:321-666-1558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator