Individual
CHOI KEN AGCADILI VELASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
675 S BABCOCK ST, MELBOURNE, FL 32901-1459
(321) 951-1010
(321) 952-4038
Mailing address
675 S BABCOCK ST, MELBOURNE, FL 32901-1459
(321) 951-1010
(321) 952-4038
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME88748
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269121300
—
FL
01
—
82005
BCBS
FL
Enumeration date
09/06/2005
Last updated
07/26/2021
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