Individual
EDIEL J VARELA DELIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
SANTURCE MEDICAL MALL, 1801 AVE PONCE DE LEON SUITE 309, SAN JUAN, PR 00909
(787) 728-1193
Mailing address
48 AVE MUNOZ RIVERA, COND AQUABLUE APT 2106, SAN JUAN, PR 00918
(787) 602-0322
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
21147
PR
390200000X
Student in an Organized Health Care Education/Training Program
14620-I
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021147
MEDICAL DOCTOR
PR
05
—
021147
—
PR
Enumeration date
04/06/2018
Last updated
11/05/2018
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