Individual
MILDRED IVETTE DIAZ VELAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
C 14 STREET URB. ALTURAS, D 54, RIO GRANDE, PR 00745-0745
(787) 250-7178
(787) 250-7178
Mailing address
14C URB. ALTURAS DE RIO GRANDE, D 54, RIO GRANDE, PR 00745-0000
(787) 250-7178
(787) 250-7178
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
558
PR
Other
Enumeration date
08/27/2008
Last updated
08/27/2008
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