Provider Demographics
NPI:1992213789
Name:VELAZQUEZ, ANAYANSI
Entity Type:Individual
Prefix:
First Name:ANAYANSI
Middle Name:
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 1:10214 SW 183RD ST
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5249
Mailing Address - Country:US
Mailing Address - Phone:305-252-4631
Mailing Address - Fax:305-232-6809
Practice Address - Street 1:10214 SW 183RD ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157-5249
Practice Address - Country:US
Practice Address - Phone:305-252-4631
Practice Address - Fax:305-232-6809
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician