1417478611 NPI number — DR. FRANCISCO JAVIER SANDOVAL VELAZQUEZ MD

Table of content: DR. FRANCISCO JAVIER SANDOVAL VELAZQUEZ MD (NPI 1417478611)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417478611 NPI number — DR. FRANCISCO JAVIER SANDOVAL VELAZQUEZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANDOVAL VELAZQUEZ
Provider First Name:
FRANCISCO
Provider Middle Name:
JAVIER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1417478611
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CENTRO COMERCIAL RIO PIEDRAS HEIGHTS
Provider Second Line Business Mailing Address:
CALEL PARANA 1689 OFIC 5
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-751-3845
Provider Business Mailing Address Fax Number:
787-294-9976

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CENTRO COMERCIAL RIO PIEDRAS HEIGH AVE. PARANA
Provider Second Line Business Practice Location Address:
SUIT 5 1689
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-751-3845
Provider Business Practice Location Address Fax Number:
787-985-9025
Provider Enumeration Date:
06/28/2017

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: 208D00000X , with the licence number:  21125 , 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)





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