1861877839 NPI number — MRS. MARILYN FRANCES VELEZ ARNP

Table of content: MRS. MARILYN FRANCES VELEZ ARNP (NPI 1861877839)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861877839 NPI number — MRS. MARILYN FRANCES VELEZ ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VELEZ
Provider First Name:
MARILYN
Provider Middle Name:
FRANCES
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JONES
Provider Other First Name:
MARILYN
Provider Other Middle Name:
F
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1861877839
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 OAK COMMONS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KISSIMMEE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34741-4213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
407-846-0626
Provider Business Mailing Address Fax Number:
407-846-2524

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 OAK COMMONS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KISSIMMEE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34741-4213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
407-846-0626
Provider Business Practice Location Address Fax Number:
407-846-2524
Provider Enumeration Date:
07/20/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  ARNP9245495 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: ARNP 9245495 . This is a "FL DEPARTMENT OF HEALTH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 110388000 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com