Provider Demographics
NPI:1922333426
Name:VELASQUEZ, BELINDA MALINAO (LPT)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:MALINAO
Last Name:VELASQUEZ
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 4TH ST SW STE 103A
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-4389
Mailing Address - Country:US
Mailing Address - Phone:319-352-6400
Mailing Address - Fax:319-352-4655
Practice Address - Street 1:1810 4TH ST SW STE 103A
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-4389
Practice Address - Country:US
Practice Address - Phone:319-352-6400
Practice Address - Fax:319-352-4655
Is Sole Proprietor?:No
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2098225100000X, 2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0665992Medicaid
IA166599Medicare Oscar/Certification