Organization
IMPOWER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISABEL VELASQUEZ (CFO)
(407) 215-0095
Entity
Organization
Contact information
Practice address
808 W CENTRAL BLVD, ORLANDO, FL 32805-1809
(407) 215-0095
(407) 261-0523
Mailing address
2290 N RONALD REAGAN BLVD STE 116, LONGWOOD, FL 32750-3534
(407) 215-0095
(407) 261-0523
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36212505
—
FL
Enumeration date
03/31/2026
Last updated
04/02/2026
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