Provider Demographics
NPI:1649600891
Name:VELEZ, RAUL F (CST, FA)
Entity Type:Individual
Prefix:MR
First Name:RAUL
Middle Name:F
Last Name:VELEZ
Suffix:
Gender:M
Credentials:CST, FA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14139 BUDWORTH CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-6123
Mailing Address - Country:US
Mailing Address - Phone:407-243-1894
Mailing Address - Fax:407-243-1894
Practice Address - Street 1:14139 BUDWORTH CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-6123
Practice Address - Country:US
Practice Address - Phone:407-243-1894
Practice Address - Fax:407-243-1894
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-24
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical