Provider Demographics
NPI:1124377064
Name:VELASQUEZ, ALEX HERNAN (MD)
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:HERNAN
Last Name:VELASQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 NW 14TH ST STE 510
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33125-1659
Mailing Address - Country:US
Mailing Address - Phone:305-243-5554
Mailing Address - Fax:305-243-5565
Practice Address - Street 1:1321 NW 14TH ST STE 510
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-1659
Practice Address - Country:US
Practice Address - Phone:305-243-5554
Practice Address - Fax:305-243-5565
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6543207R00000X
390200000X
FLME140181207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program