Healthcare Provider Details
I. General information
NPI: 1851188668
Provider Name (Legal Business Name): DR. CAROLINE VANESSA VELAZQUEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/23/2025
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
HC 3 BOX 8881
GUAYNABO PR
00971-9733
US
IV. Provider business mailing address
HC 03 BOX 8881
GUAYNABO PR
00971-9733
US
V. Phone/Fax
- Phone: 939-226-1298
- Fax:
- Phone: 939-226-1298
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | 25113 |
| License Number State | PR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: