1770685026 NPI number — DR. JESUS VELEZ-FELICIANO M.D.

Table of content: DR. JESUS VELEZ-FELICIANO M.D. (NPI 1770685026)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770685026 NPI number — DR. JESUS VELEZ-FELICIANO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VELEZ-FELICIANO
Provider First Name:
JESUS
Provider Middle Name:
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:
1770685026
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/05/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CALLE 1 A 19
Provider Second Line Business Mailing Address:
VILLAS DE LEVITTON
Provider Business Mailing Address City Name:
TOA BAJA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00949-4902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-261-4589
Provider Business Mailing Address Fax Number:
787-261-4589

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
112 CALLE ARZUAGA
Provider Second Line Business Practice Location Address:
CONDOMINIO MEDINA CENTER OF 606
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00925-3321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-764-8296
Provider Business Practice Location Address Fax Number:
787-764-8296
Provider Enumeration Date:
09/05/2006

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: 207VX0000X , with the licence number:  7539 , 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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