Provider Demographics
NPI:1245443712
Name:VELASCO, ALVIN LIRIO (RN)
Entity type:Individual
Prefix:MR
First Name:ALVIN
Middle Name:LIRIO
Last Name:VELASCO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:749 NE 95 STREET
Mailing Address - Street 2:
Mailing Address - City:MIAMI SHORES
Mailing Address - State:FL
Mailing Address - Zip Code:33138-2514
Mailing Address - Country:US
Mailing Address - Phone:305-757-6294
Mailing Address - Fax:
Practice Address - Street 1:749 NE 95 STREET
Practice Address - Street 2:
Practice Address - City:MIAMI SHORES
Practice Address - State:FL
Practice Address - Zip Code:33138-2514
Practice Address - Country:US
Practice Address - Phone:305-757-6294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 2988762163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency