Provider Demographics
NPI:1972182533
Name:VELEZ, MICHAEL R (MD, MTM)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:VELEZ
Suffix:
Gender:M
Credentials:MD, MTM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 E SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33133-7009
Mailing Address - Country:US
Mailing Address - Phone:305-992-6012
Mailing Address - Fax:
Practice Address - Street 1:41 E SUNRISE AVE
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33133-7009
Practice Address - Country:US
Practice Address - Phone:305-992-6012
Practice Address - Fax:305-701-3128
Is Sole Proprietor?:No
Enumeration Date:2021-04-02
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA193111208D00000X
VA0101281685208D00000X
FLME167122208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice