Healthcare Provider Details

I. General information

NPI: 1124094768
Provider Name (Legal Business Name): LEYDA Z OQUENDO-VELEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BB28 AVE SANTA JUANITA
BAYAMON PR
00956-4633
US

IV. Provider business mailing address

UU-1 CALLE 39 PMB 318
BAYAMON PR
00956-5582
US

V. Phone/Fax

Practice location:
  • Phone: 787-600-2989
  • Fax:
Mailing address:
  • Phone: 787-600-2989
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12581
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: