Healthcare Provider Details

I. General information

NPI: 1972640209
Provider Name (Legal Business Name): ELIUD LOPEZ VELEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CONDOMINIO EL CENTRO II LOCAL 21
HATO REY PR
00918
US

IV. Provider business mailing address

PO BOX 364747
HATO REY PR
00936-4747
US

V. Phone/Fax

Practice location:
  • Phone: 787-759-7822
  • Fax: 787-759-8887
Mailing address:
  • Phone: 787-759-7822
  • Fax: 787-759-8887

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number2675
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: