Provider Demographics
NPI:1902022098
Name:VELEZ, STELLA I (MA, ITDS, CFLE)
Entity Type:Individual
Prefix:MRS
First Name:STELLA
Middle Name:I
Last Name:VELEZ
Suffix:
Gender:F
Credentials:MA, ITDS, CFLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15780 78TH DR N
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-1856
Mailing Address - Country:US
Mailing Address - Phone:561-746-2110
Mailing Address - Fax:772-409-8694
Practice Address - Street 1:15780 78TH DR N
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-1856
Practice Address - Country:US
Practice Address - Phone:561-746-2110
Practice Address - Fax:772-409-8694
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000368400Medicaid