# JUAN C. VELASCO CERVILLA MD CSP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275537763
- **Authorized official:** DR. JUAN CARLOS VELASCO- CERVILLA M.D. (PRESIDENT)
- **Authorized official phone:** (787) 267-2811

## Contact information

- **Practice address:** 40 - 25 DE JULIO, YAUCO, PR 00698-0000
- **Practice address phone:** (787) 267-2811
- **Practice address fax:** (787) 267-1964
- **Mailing address:** PO BOX 3004, YAUCO, PR 00698-3004
- **Mailing address phone:** (787) 267-2811
- **Mailing address fax:** (787) 267-1964

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 10541 | PR | Yes |
| 207R00000X | Internal Medicine Physician | 15870 | PR | — |

## Other

- **Enumeration date:** 06/13/2005
- **Last updated:** 08/30/2016