Provider Demographics
NPI:1548447592
Name:VELOSA, CLARA E (PT)
Entity type:Individual
Prefix:MRS
First Name:CLARA
Middle Name:E
Last Name:VELOSA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1850 OLD DIXIE HWY STE 2
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33033-3212
Mailing Address - Country:US
Mailing Address - Phone:786-678-4479
Mailing Address - Fax:305-508-6712
Practice Address - Street 1:1850 OLD DIXIE HWY STE 2
Practice Address - Street 2:
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33033-3212
Practice Address - Country:US
Practice Address - Phone:786-678-4479
Practice Address - Fax:305-508-6712
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT77492081N0008X, 2251G0304X, 2251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular Medicine
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101184000Medicaid
FLAY281ZMedicare PIN
FLAY281ZMedicare PIN