Provider Demographics
NPI:1194553354
Name:VELAZCO GARCIA, LIANET
Entity type:Individual
Prefix:
First Name:LIANET
Middle Name:
Last Name:VELAZCO GARCIA
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 1:474 E 27TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3626
Mailing Address - Country:US
Mailing Address - Phone:786-525-8146
Mailing Address - Fax:
Practice Address - Street 1:474 E 27TH ST APT 6
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3626
Practice Address - Country:US
Practice Address - Phone:786-525-8146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool