Healthcare Provider Details
I. General information
NPI: 1053108969
Provider Name (Legal Business Name): CIRUJANO DE HUESOS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/23/2025
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
500 AVE DEGETAU STE 302
CAGUAS PR
00725-7303
US
IV. Provider business mailing address
1404 CALLE CONVENIENCIA APT 301
SAN JUAN PR
00907-1612
US
V. Phone/Fax
- Phone: 787-772-1007
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207XS0114X |
| Taxonomy | Adult Reconstructive Orthopaedic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DENCEL
GARCIA VELEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 787-428-5991