Organization
INTERMED EAST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS IDIA L VELAZQUEZ (M.D.)
(787) 342-8201
Entity
Organization
Contact information
Practice address
FONT MARTELO 123 STREET, HUMACAO, PR 00791
(787) 852-3417
(787) 859-7861
Mailing address
PO BOX 1197, LAS PIEDRAS, PR 00771-1197
(787) 342-8201
(787) 850-7861
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13901
PR
Other
Enumeration date
04/25/2014
Last updated
04/25/2014
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