Provider Demographics
NPI:1659964112
Name:MARICHAL VELOZ, MARIA ELENA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ELENA
Last Name:MARICHAL VELOZ
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 1:5901 NW 151ST ST STE 122
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33014-2454
Mailing Address - Country:US
Mailing Address - Phone:786-409-5544
Mailing Address - Fax:305-397-1113
Practice Address - Street 1:5901 NW 151ST ST STE 122
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33014-2454
Practice Address - Country:US
Practice Address - Phone:786-409-5544
Practice Address - Fax:305-397-1113
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11043690363LF0000X
104100000X
FLRN9492707163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108255300Medicaid