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Individual
FABIAN VELAZQUEZ LOPEZ
Active
Individual
FABIAN VELAZQUEZ LOPEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5071
PR
208D00000X
General Practice Physician
5071
PR
Other
Enumeration date
06/09/2006
Last updated
05/17/2012
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