Provider Demographics
NPI:1245992098
Name:VELAZQUEZ SALCEDO, IRMA BARBARA (ARNP)
Entity type:Individual
Prefix:
First Name:IRMA
Middle Name:BARBARA
Last Name:VELAZQUEZ SALCEDO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5891 W 21ST CT
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33016-2632
Mailing Address - Country:US
Mailing Address - Phone:786-278-9731
Mailing Address - Fax:
Practice Address - Street 1:5891 W 21ST CT
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33016-2632
Practice Address - Country:US
Practice Address - Phone:786-278-9731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-08
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011579363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner