Provider Demographics
NPI:1629134952
Name:BLAS VELEZ, NANCY (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:BLAS VELEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 S DOUGLAS RD STE 308
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-6134
Mailing Address - Country:US
Mailing Address - Phone:813-859-5449
Mailing Address - Fax:
Practice Address - Street 1:6836 MEDICAL VIEW LN
Practice Address - Street 2:
Practice Address - City:ZEPHYRHILLS
Practice Address - State:FL
Practice Address - Zip Code:33542-6615
Practice Address - Country:US
Practice Address - Phone:813-859-5449
Practice Address - Fax:813-395-5478
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16116208D00000X
FLACN700208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR016116OtherLIC MEDICA
FL023040300Medicaid
FLACN700OtherMEDICAL LICENSE NUMBER