Individual provider Active NPI

Kenya Maria Rivas Velasquez, MD

  • Adult Medicine Physician
  • Orlando, FL
National Provider Identifier
1134395288
Registry record updated Oct 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
ME101221 Issued in FL
Practice address
2501 N Orange Ave Ste 235
Orlando, FL 32804-4659
Phone
(407) 303-1967
Fax
(407) 303-2517
NPI assigned
May 7, 2008
Last updated
Oct 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X ME101221 FL Primary

Addresses

Primary practice location

2501 N Orange Ave Ste 235
Orlando, FL 32804-4659

Mailing address

2501 N Orange Ave Ste 235
Orlando, FL 32804-4659
Phone (407) 303-1967

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081017000205 FL Practitioner - Family Practice 7517025786 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc CurrentSince Jan 24, 2015 Accepting new patients
Nova Southeastern University, Inc Current Accepting new patients

Locations

3200 S University Dr
Davie, FL 33328
Phone (954) 262-1250

3200 S University Dr
Fl 1
Davie, FL 33328

650 N Andrews Ave
Ft Lauderdale, FL 33311
Phone (954) 463-4213

1750 NE 167th St
North Miami Beach, FL 33162
Phone (305) 949-4000

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223510400000",
    "number": "1134395288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 235",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044659",
            "telephone_number": "407-303-1967",
            "fax_number": "407-303-2517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 235",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044659",
            "telephone_number": "407-303-1967",
            "fax_number": "407-303-2517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVAS VELASQUEZ",
        "first_name": "KENYA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "FL",
            "license": "ME101221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.