Individual
LISA ANN VELASQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
501 6TH AVE S, ST PETERSBURG, FL 33701-4634
(727) 767-8480
(727) 767-8420
Mailing address
601 5TH ST S, 5TH FLOOR DEPT 6941, ST PETERSBURG, FL 33701
(727) 767-8480
(727) 767-8420
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
ME87485
FL
207LP3000X
Pediatric Anesthesiology Physician
Primary
ME87485
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
266730400
—
FL
Enumeration date
06/09/2006
Last updated
08/06/2012
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