Provider Demographics
NPI:1447458500
Name:VELEZ VELEZ, JESUS DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:JESUS
Middle Name:DANIEL
Last Name:VELEZ VELEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4980
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-4980
Mailing Address - Country:US
Mailing Address - Phone:787-653-3434
Mailing Address - Fax:787-961-1901
Practice Address - Street 1:100 AVE LUIS MUNOZ MARIN
Practice Address - Street 2:HOSPITAL HIMA SAN PABLO CAGUAS
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-6184
Practice Address - Country:US
Practice Address - Phone:787-653-3434
Practice Address - Fax:787-961-1901
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR194872085R0202X, 2085R0204X
DEC7-00037802085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR19487OtherMEDICAL LICENSE
FLME117750OtherMEDICAL LICENSE