Provider Demographics
NPI:1124798202
Name:VELIZ, IDANIA
Entity type:Individual
Prefix:
First Name:IDANIA
Middle Name:
Last Name:VELIZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11921 SW 271ST TER
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-3305
Mailing Address - Country:US
Mailing Address - Phone:786-623-7509
Mailing Address - Fax:
Practice Address - Street 1:11921 SW 271ST TER
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33032-3305
Practice Address - Country:US
Practice Address - Phone:786-623-7509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician