Organization Active NPI

Fernando J Velasquez MD PA

  • Pediatrics Physician
  • Tampa, FL
National Provider Identifier
1043382070
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME39936 Issued in FL
Legal business name
FERNANDO J VELASQUEZ MD PA
Practice address
2906 West Tampa Bay Boulevard
Tampa, FL 33607-1233
Phone
(813) 879-1985
Fax
(813) 876-0336
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Fernando Jose Velasquez, MD
Title
Physician
Phone
(813) 879-1985

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X ME39936 FL Primary

Addresses

Primary practice location

2906 West Tampa Bay Boulevard
Tampa, FL 33607-1233

Mailing address

2906 West Tampa Bay Blvd
Tampa, FL 33607-1233
Phone (813) 879-1985

Other identifiers 1

IdentifierTypeStateIssuer
77331OtherFLBCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043382070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 WEST TAMPA BAY BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336071233",
            "telephone_number": "813-879-1985",
            "fax_number": "813-876-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 WEST TAMPA BAY BOULEVARD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336071233",
            "telephone_number": "813-879-1985",
            "fax_number": "813-876-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERNANDO J VELASQUEZ MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VELASQUEZ",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "813-879-1985",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME39936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "77331",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.