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Individual

JOSE A VELEZ MEDIAVILLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
CARR 119 KM 1.2, BO CALABAZA, SAN SEBASTIAN, PR 00685-5215
(787) 280-2532
Mailing address
PO BOX 5215, SAN SEBASTIAN, PR 00685-5215
(787) 280-2532

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
TCAMB 455
PR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1275664005
MCS REFORMA
PR
01
50741
PMC
PR
01
9962
AMERICAN HEALTH MEDICARE
PR
Enumeration date
03/07/2007
Last updated
10/14/2009
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