Provider Demographics
NPI:1144479825
Name:FERNANDEZ VELAZQUEZ, DAISY (MTS)
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:FERNANDEZ VELAZQUEZ
Suffix:
Gender:F
Credentials:MTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3484 CALLE INDICO
Mailing Address - Street 2:URBANIZACION OCEAN FRONT
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-6114
Mailing Address - Country:US
Mailing Address - Phone:787-345-8060
Mailing Address - Fax:787-740-4175
Practice Address - Street 1:3484 CALLE INDICO
Practice Address - Street 2:URBANIZACION OCEAN FRONT
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-6114
Practice Address - Country:US
Practice Address - Phone:787-345-8060
Practice Address - Fax:787-740-4175
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical