Look up the most recent NPI and PECOS records

Octavio Perez-Velasco M D P A

Family Medicine

Allopathic & Osteopathic Physicians

1312 W Fletcher Ave, Ste A, Tampa, FL 33612-3330

PECOS Enrollment

Based on the most recent information from CMS, provider Octavio Perez-Velasco M D P A does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 40 days ago.

Profile Details

Provider ID
1083865869
Provider Type
Organization
Full Name
Octavio Perez-Velasco M D P A

Subpart
No
Enumeration Date
10/10/2008
Last Updated
4/23/2024

Contact Information

Practice Location

1312 W Fletcher Ave, Ste A, Tampa, FL 33612-3330

(813) 964-0595

(813) 963-5071

Mailing Location

1312 W Fletcher Ave, Ste A, Tampa, FL 33612-3330

(813) 964-0595

(813) 963-5071

Authorized Official

Perez-Velasco, Octavio (President)

(813) 964-0595

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License Unlisted Issuer
Code 261QP2300X	Description Clinic/Center Ambulatory Health Care Facilities	License ME81174 Florida

Octavio Perez-Velasco M D P A

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Costa, Jennifer Catherine

Moonjeli, Shirly S

Walicki, Celeste L.

Menold, Victoria Ostheimer

Olson, Christopher E

Uhlar, Courtney L

Morgan, Caitlin Sarah

Bhamidipati, Savithri

Jaramillo, Carmen Guadalupe

Complete Primary/Urgent Care Llc