Healthcare Provider Details

I. General information

NPI: 1104352681
Provider Name (Legal Business Name): YOANNERIS VELEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YOANNERIS VELEZ THL

II. Dates (important events)

Enumeration Date: 05/03/2017
Last Update Date: 05/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66 URB CATALANA
BARCELONETA PR
00617-2725
US

IV. Provider business mailing address

PO BOX 2020 PMB 288
BARCELONETA PR
00617-2020
US

V. Phone/Fax

Practice location:
  • Phone: 178-791-5300
  • Fax:
Mailing address:
  • Phone: 178-791-5300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number3046
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier4972487
Identifier TypeOTHER
Identifier StatePR
Identifier IssuerFIRST MEDICAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: