Provider Demographics
NPI:1619947041
Name:VELEZ-HOLVINO, OSCAR DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:DAVID
Last Name:VELEZ-HOLVINO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:OSCAR
Other - Middle Name:D
Other - Last Name:VELEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1291 BLOOMINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-6168
Mailing Address - Country:US
Mailing Address - Phone:813-653-1880
Mailing Address - Fax:813-654-2778
Practice Address - Street 1:1291 BLOOMINGDALE AVE
Practice Address - Street 2:
Practice Address - City:VALRICO
Practice Address - State:FL
Practice Address - Zip Code:33596-6168
Practice Address - Country:US
Practice Address - Phone:813-653-1880
Practice Address - Fax:813-654-2778
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35056252207Q00000X
FLME126243207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0818431Medicaid
OHF56252OtherSUMMA
FL016274300Medicaid
110191177OtherRAILROAD MEDICARE
OH000000128729OtherANTHEM
110191177OtherRAILROAD MEDICARE
OHF56252OtherSUMMA