Provider Demographics
NPI:1902935026
Name:VELEZ AROCHO, DIANA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:VELEZ AROCHO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SUPERIOR EMERGENCY
Other - Middle Name:
Other - Last Name:CARE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1563
Mailing Address - Street 2:
Mailing Address - City:SANSEBASTIAN
Mailing Address - State:PR
Mailing Address - Zip Code:00685
Mailing Address - Country:US
Mailing Address - Phone:787-354-7890
Mailing Address - Fax:
Practice Address - Street 1:7 CALLE JUSTINA HERNADEZ
Practice Address - Street 2:
Practice Address - City:SAN SEBASTIAN
Practice Address - State:PR
Practice Address - Zip Code:00685
Practice Address - Country:US
Practice Address - Phone:787-354-7890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRTCAMB5093416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR660690974OtherMCS REFORMA
PR0059724Medicare PIN