Provider Demographics
NPI:1942599212
Name:VELAZQUEZ, MARIA NIEVES
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:NIEVES
Last Name:VELAZQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR 129 KM 4.4
Mailing Address - Street 2:HC 01 BOX 4128
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601
Mailing Address - Country:UM
Mailing Address - Phone:787-829-5029
Mailing Address - Fax:
Practice Address - Street 1:CARR 129 KM 4 4
Practice Address - Street 2:HC 01 BOX 4128
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601-9710
Practice Address - Country:US
Practice Address - Phone:787-829-5029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7880183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician