Provider Demographics
NPI:1700351871
Name:VELAZQUEZ, RAQUEL IVETTE (ACNP)
Entity type:Individual
Prefix:MRS
First Name:RAQUEL
Middle Name:IVETTE
Last Name:VELAZQUEZ
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 MEMORIAL MEDICAL PKWY STE 505
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-5170
Mailing Address - Country:US
Mailing Address - Phone:386-231-3540
Mailing Address - Fax:386-231-3544
Practice Address - Street 1:305 MEMORIAL MEDICAL PKWY STE 505
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32117-5170
Practice Address - Country:US
Practice Address - Phone:386-231-3540
Practice Address - Fax:386-231-3544
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11000382363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care