Organization
PROF/GUIDEWELL SANITAS MED CNT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HUGO HERNAN VELARDE-LASSO M.D (PHYSIAN)
(516) 353-5770
Entity
Organization
Contact information
Practice address
11211 VERANDA CT, BRADENTON, FL 34209-7101
(516) 353-5770
Mailing address
11211 VERANDA CT, BRADENTON, FL 34209-7101
(516) 353-5770
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
226893
NY
261Q00000X
Clinic/Center
Primary
ME125796
FL
261QA0600X
Adult Day Care Clinic/Center
ME125796
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02488824
—
NY
05
—
H83144
—
NY
Enumeration date
10/21/2016
Last updated
10/21/2016
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