# JOSE A VELEZ MEDIAVILLA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1275664005
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | TCAMB 455 | PR | Yes |

## Other

- **Enumeration date:** 03/07/2007
- **Last updated:** 10/14/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1275664005 | MCS CLASSICARE | PR |
| 01 | — | 50741 | PMC | PR |
| 01 | — | 9962 | AMERICAN HEALTH MEDICARE | PR |