Provider Demographics
NPI:1023105632
Name:VELEZ, BAUDILIO JOSE' (ARNP)
Entity type:Individual
Prefix:
First Name:BAUDILIO
Middle Name:JOSE'
Last Name:VELEZ
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 26028
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87125-6028
Mailing Address - Country:US
Mailing Address - Phone:505-232-1617
Mailing Address - Fax:505-262-7729
Practice Address - Street 1:5150 JOURNAL CENTER BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-5900
Practice Address - Country:US
Practice Address - Phone:505-262-3212
Practice Address - Fax:505-232-1532
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-03146363L00000X, 363LP2300X
FLARNP2742702363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM13835220Medicaid
FL30797088Medicaid
FLP00657716OtherMEDICARE RR
FLAQ398ZMedicare PIN
FL1168350001Medicare NSC