Healthcare Provider Details

I. General information

NPI: 1740153261
Provider Name (Legal Business Name): ISMAEL ALBERTO VELEZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2025
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1490 CARR 19
GUAYNABO PR
00966-2720
US

IV. Provider business mailing address

1490 CARR 19
GUAYNABO PR
00966-2720
US

V. Phone/Fax

Practice location:
  • Phone: 787-783-2226
  • Fax:
Mailing address:
  • Phone: 787-783-2226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number7097
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: