Provider Demographics
NPI:1164628616
Name:VELEZ, MANUEL A (MD)
Entity type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:A
Last Name:VELEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MANUEL
Other - Middle Name:A
Other - Last Name:VELEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2025
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960-2025
Mailing Address - Country:US
Mailing Address - Phone:787-642-1868
Mailing Address - Fax:
Practice Address - Street 1:EDIFICIO MEDICO HERMANAS DAVILA,OFICINA #206
Practice Address - Street 2:EXTENSION VILLA RICA
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00959
Practice Address - Country:US
Practice Address - Phone:787-642-1868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16191208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation