Individual
DUARTE VELOSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
600 E DIXIE AVE, EMERGENCY DEPARTMENT, LEESBURG, FL 34748-5925
(919) 425-1565
(919) 425-0478
Mailing address
3114 CROASDAILE DR, SUITE 200, DURHAM, NC 27705-2508
(919) 425-1565
(919) 425-0478
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103207
FL
363AM0700X
Medical Physician Assistant
9103207
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292237100
—
FL
01
—
P00296777
RR MCR
—
Enumeration date
12/20/2005
Last updated
11/06/2009
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