Organization Name: | MIGUEL VELAZQUEZ DO, P.A. |
NPI Number: | 1174855449 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MIGUEL VELAZQUEZ (OWNER/PHYSICIAN) |
Mailing Address: | 344 Cumberland St Westbrook |
State: | ME US |
Postal Code: | 040922408 |
Phone Number: | 2078548200 |
Fax Number: | 8777352638 |
NPI Enumeration Date: | 02/11/2010 |
NPI Last Update Date: | 02/11/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 204D00000X |
License Number: | 1761 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
Taxonomy Specialization: | |
Taxonomy Definition: |