Provider Demographics
NPI:1396282984
Name:VELEZ, ALEXANDRO HERMAN
Entity type:Individual
Prefix:MR
First Name:ALEXANDRO
Middle Name:HERMAN
Last Name:VELEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6787 W TROPICANA AVE
Mailing Address - Street 2:SUITE 120A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-4757
Mailing Address - Country:US
Mailing Address - Phone:702-659-8827
Mailing Address - Fax:
Practice Address - Street 1:6787 W TROPICANA AVE
Practice Address - Street 2:SUITE 120A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-4757
Practice Address - Country:US
Practice Address - Phone:702-659-8827
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-20
Last Update Date:2017-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6938-S104100000X
NVIC-9441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker