Provider Demographics
NPI:1730426636
Name:VELEZ-BARRETO, EDWIN (PSYD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:
Last Name:VELEZ-BARRETO
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. VILLA SULTANITA CALLE E. DE IRIZARRY #871
Mailing Address - Street 2:
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680
Mailing Address - Country:US
Mailing Address - Phone:787-205-6438
Mailing Address - Fax:
Practice Address - Street 1:DOCTOR'S CENTER SUITE # 103
Practice Address - Street 2:PEDRO PEREA ST. # 27
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-205-6438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4056103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical