Provider Demographics
NPI:1154709376
Name:VELEZ, BRENDA (M ED)
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:
Last Name:VELEZ
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 N GOLDENROD RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-8308
Mailing Address - Country:US
Mailing Address - Phone:407-704-7811
Mailing Address - Fax:
Practice Address - Street 1:139 APPLE BLOSSOM CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-6101
Practice Address - Country:US
Practice Address - Phone:407-692-4980
Practice Address - Fax:407-692-4980
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
FL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor