Individual
MARTHA GEORGETTE VELEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1000 WATERMAN WAY, TAVARES, FL 32778-5266
(407) 667-0505
Mailing address
1637 WILLOW OAK LN, SANFORD, FL 32773-8199
(407) 474-7778
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
11002809
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
11002809
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
V420547725290
DRIVER LICENCE
FL
Enumeration date
06/26/2019
Last updated
06/26/2019
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