Provider Demographics
NPI:1861547101
Name:VELAZQUEZ MUNOZ, MELVIN JUAN (MD)
Entity type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:JUAN
Last Name:VELAZQUEZ MUNOZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MELVIN
Other - Middle Name:JUAN
Other - Last Name:VELAZQUEZ MUNOZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:HUMACAO MEDICAL PLAZA
Mailing Address - Street 2:OFICINA 203 CALLE FONT MARTELO H53
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791
Mailing Address - Country:US
Mailing Address - Phone:787-365-1999
Mailing Address - Fax:787-285-1970
Practice Address - Street 1:HUMACAO MEDICAL PLAZA
Practice Address - Street 2:OFICINA 203 CALLE FONT MARTELO H53
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-365-1999
Practice Address - Fax:787-285-1970
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9849101YM0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF72608Medicare UPIN