Provider Demographics
NPI:1700164829
Name:VELEZ ISAZA, CAROLINA (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLINA
Middle Name:
Last Name:VELEZ ISAZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CAROLINA
Other - Middle Name:
Other - Last Name:VELEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:200 CORPORATE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3870
Mailing Address - Country:US
Mailing Address - Phone:800-893-9698
Mailing Address - Fax:
Practice Address - Street 1:8833 LAKESHORE BEND DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080
Practice Address - Country:US
Practice Address - Phone:646-301-4421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117655207P00000X
TXP7998207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine