Healthcare Provider Details

I. General information

NPI: 1972574192
Provider Name (Legal Business Name): VELEZ CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 S CENTER AVE
SOMERSET PA
15501-2033
US

IV. Provider business mailing address

1699 WASHINGTON RD STE 307
PITTSBURGH PA
15228-1629
US

V. Phone/Fax

Practice location:
  • Phone: 814-443-5000
  • Fax:
Mailing address:
  • Phone: 412-831-3744
  • Fax: 412-831-5663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: RAFAEL I VELEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 814-443-5000