Provider Demographics
NPI:1316999378
Name:VELEZ-VELEZ, DAISY IVELLISSE (MD)
Entity type:Individual
Prefix:DR
First Name:DAISY
Middle Name:IVELLISSE
Last Name:VELEZ-VELEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6982 LAKE NONA BLVD APT 516
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32827-7898
Mailing Address - Country:US
Mailing Address - Phone:787-312-6708
Mailing Address - Fax:
Practice Address - Street 1:493 STATE ROAD 436
Practice Address - Street 2:
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-4912
Practice Address - Country:US
Practice Address - Phone:321-235-6230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16398208D00000X
FLACN1258208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLO75333OtherMEDICARE