1689986895 NPI number — DR. BRAULIO CESAR VELAZQUEZ M.D

Table of content: DR. BRAULIO CESAR VELAZQUEZ M.D (NPI 1689986895)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689986895 NPI number — DR. BRAULIO CESAR VELAZQUEZ M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VELAZQUEZ
Provider First Name:
BRAULIO
Provider Middle Name:
CESAR
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D
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:
1689986895
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
COND MANSIONES LOS CAOBOS
Provider Second Line Business Mailing Address:
APT 17 B AVE SAN PATRICIO J6
Provider Business Mailing Address City Name:
GUAYNABO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00968
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-405-2098
Provider Business Mailing Address Fax Number:
787-285-1970

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HUMACAO MEDICAL PLAZA AVE FONT MARTELO 53
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
HUMACAO
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00791
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-285-1270
Provider Business Practice Location Address Fax Number:
787-285-1970
Provider Enumeration Date:
07/06/2010

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:  15757 , 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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