Individual provider Active NPI

Andrea Jean Velasco, CRNP

  • Pediatric Clinical Nurse Specialist
  • Tampa, FL
National Provider Identifier
1326168014
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Clinical Nurse SpecialistTaxonomy code 364SP0200X
License
ARNP212062 Issued in FL
Practice address
3003 W Dr MLK Jr Blvd
Mab 2ND Floor
Tampa, FL 33607-6307
Phone
(727) 767-4510
Fax
(727) 767-2638
NPI assigned
Mar 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Clinical Nurse Specialist 364SP0200X ARNP212062 FL Primary

Addresses

Primary practice location

3003 W Dr MLK Jr Blvd
Mab 2ND Floor
Tampa, FL 33607-6307

Mailing address

3003 W Dr MLK Jr Blvd
Mab 2ND Floor
Tampa, FL 33607-6307
Phone (727) 767-4510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
ARNP212062FLMDPediatric Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1326168014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3003 W DR MLK JR BLVD",
            "address_2": "MAB 2ND FLOOR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076307",
            "telephone_number": "727-767-4510",
            "fax_number": "727-767-2638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 W DR MLK JR BLVD",
            "address_2": "MAB 2ND FLOOR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076307",
            "telephone_number": "727-767-4510",
            "fax_number": "727-767-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VELASCO",
        "first_name": "ANDREA",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-29",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Pediatrics",
            "state": "FL",
            "license": "ARNP212062",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 28, 2012; 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.