1366673246 NPI number — ERIK JAVIER CARO VELEZ M.D.

Table of content: ERIK JAVIER CARO VELEZ M.D. (NPI 1366673246)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366673246 NPI number — ERIK JAVIER CARO VELEZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARO VELEZ
Provider First Name:
ERIK
Provider Middle Name:
JAVIER
Provider Name Prefix Text:
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:
CARO VELEZ
Provider Other First Name:
ERIK
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1366673246
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
67 GIRALDA STREET
Provider Second Line Business Mailing Address:
URB. SULTANA
Provider Business Mailing Address City Name:
MAYAGUEZ
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00680
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-519-4795
Provider Business Mailing Address Fax Number:
939-649-4007

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MVC BUILDING STE 102
Provider Second Line Business Practice Location Address:
RAMON EMETERIO BETANCES 7 ESQ. DE DIEGO
Provider Business Practice Location Address City Name:
MAYAGUEZ
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00680-1085
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-983-0911
Provider Business Practice Location Address Fax Number:
939-649-4007
Provider Enumeration Date:
07/27/2009

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:  17659 , 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: 039221700 , issued by the state of ( PR ) . This identifiers is of the category "MEDICAID".




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