Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | FL | |
N | 101YP1600X | Pastoral Counselor | FL | |
Y | 102L00000X | Psychologist | FL | |
Y | 103T00000X | Psychologist | FL | |
N | 103TC1900X | Counseling Psychologist | FL |
NPI | 1003400813 |
---|---|
Provider Name | Juan Alejandro Velez |
First Address | Orlando, FL 32828-7500 |
Second Address | Saint Cloud, FL 34769-7203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2021 |
Last Update Date | 03/03/2021 |