Individual
VANESSA VELAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
GO4-B CAMPO RICO AVENUE, COUNTRY CLUB, CAROLINA, PR 00982
(787) 750-0444
(787) 750-0195
Mailing address
110 PLAZA SILVESTRE, ENTRERIOS, TRUJILLO ALTO, PR 00976-6169
(787) 283-0421
(787) 750-0195
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11366
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11036-1
STATE NARCOTIC LICENSE
PR
01
—
11366
STATE LICENSE
PR
01
—
BV4042254
FEDERAL NARCOTIC LICENSE
PR
Enumeration date
01/08/2007
Last updated
07/09/2007
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