Provider Demographics
NPI:1851399851
Name:VELAZQUEZ, JOSE L (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:L
Last Name:VELAZQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1074
Mailing Address - Street 2:C/O ANESTHESIA ASSOCIATES OF DUNEDIN
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34697-1074
Mailing Address - Country:US
Mailing Address - Phone:727-734-6932
Mailing Address - Fax:727-734-4516
Practice Address - Street 1:646 VIRGINIA ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-6612
Practice Address - Country:US
Practice Address - Phone:727-734-6932
Practice Address - Fax:727-734-4516
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME21041207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL055507000Medicaid
FL52866OtherBCBS OF FLORIDA
FL051907247OtherRAILROAD MEDICARE PROVIDER NUMBER
FL52866YMedicare PIN
FL051907247OtherRAILROAD MEDICARE PROVIDER NUMBER