Provider Demographics
NPI:1972901064
Name:VELEZ FAMILY HEALTH, LLC
Entity Type:Organization
Organization Name:VELEZ FAMILY HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-356-6864
Mailing Address - Street 1:7575 DR PHILLIPS BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-7221
Mailing Address - Country:US
Mailing Address - Phone:407-530-6591
Mailing Address - Fax:855-817-7755
Practice Address - Street 1:7575 DR PHILLIPS BLVD STE 120
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-7221
Practice Address - Country:US
Practice Address - Phone:407-530-6591
Practice Address - Fax:855-817-7755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-05
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME111142261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care