Provider Demographics
NPI:1619715927
Name:VELAZQUEZ CAMPOS, ALBERTO CARLOS I
Entity type:Individual
Prefix:MR
First Name:ALBERTO
Middle Name:CARLOS
Last Name:VELAZQUEZ CAMPOS
Suffix:I
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 1:165 E 9TH ST APT 13
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4235
Mailing Address - Country:US
Mailing Address - Phone:786-334-8309
Mailing Address - Fax:
Practice Address - Street 1:165 E 9TH ST APT 13
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4235
Practice Address - Country:US
Practice Address - Phone:786-334-8309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-19
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-24-358001106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician