Provider Demographics
NPI:1730314469
Name:VELAZQUEZ, VALERIE TIRADO
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:TIRADO
Last Name:VELAZQUEZ
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 1:390 112TH AVE N
Mailing Address - Street 2:APT 6-111
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-3505
Mailing Address - Country:US
Mailing Address - Phone:813-780-2375
Mailing Address - Fax:813-355-3993
Practice Address - Street 1:31511 SADDLE LN
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33543-4772
Practice Address - Country:US
Practice Address - Phone:813-780-2375
Practice Address - Fax:813-355-3993
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist