Provider Demographics
NPI:1760288864
Name:VELAZQUEZ VELAZQUEZ, WILMINET (PA)
Entity type:Individual
Prefix:
First Name:WILMINET
Middle Name:
Last Name:VELAZQUEZ VELAZQUEZ
Suffix:
Gender:
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 2 BOX 7165
Mailing Address - Street 2:
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-9784
Mailing Address - Country:US
Mailing Address - Phone:787-909-8865
Mailing Address - Fax:
Practice Address - Street 1:DESVIO ANIBAL GARCIA RAMAL 9922
Practice Address - Street 2:BO COLLORES LOCAL C
Practice Address - City:LAS PIEDRAS
Practice Address - State:PR
Practice Address - Zip Code:00771
Practice Address - Country:US
Practice Address - Phone:787-705-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24335208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice