1912031816 NPI number — MAYRA VELEZ P.H.

Table of content: MAYRA VELEZ P.H. (NPI 1912031816)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912031816 NPI number — MAYRA VELEZ P.H.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VELEZ
Provider First Name:
MAYRA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.H.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912031816
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 486
Provider Second Line Business Mailing Address:
PILETAS ARCE
Provider Business Mailing Address City Name:
LARES
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00669-0486
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-897-7012
Provider Business Mailing Address Fax Number:
787-897-2725

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
STREET 111 HM 1.9
Provider Second Line Business Practice Location Address:
AVE. LOS PATRIOTAS
Provider Business Practice Location Address City Name:
LARES
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00669
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-897-2727
Provider Business Practice Location Address Fax Number:
787-897-2725
Provider Enumeration Date:
03/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  3136 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 3136 . This is a "PHARMACIST" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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