Provider Demographics
NPI:1871757682
Name:VELEZ, DIANA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:VELEZ
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 1:2138 CALLE ROMA
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-4816
Mailing Address - Country:US
Mailing Address - Phone:787-872-2410
Mailing Address - Fax:787-872-2410
Practice Address - Street 1:2138 CALLE ROMA
Practice Address - Street 2:
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662-4816
Practice Address - Country:US
Practice Address - Phone:787-872-2410
Practice Address - Fax:787-872-2410
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR006164246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other