Healthcare Provider Details

I. General information

NPI: 1053215772
Provider Name (Legal Business Name): WILMARI VELEZ-FELICIANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 AVE NOEL ESTRADA
ISABELA PR
00662-3275
US

IV. Provider business mailing address

URB. 3T CALLE BROMELIA #10
ISABELA PR
00662
US

V. Phone/Fax

Practice location:
  • Phone: 787-669-3815
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number9232
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: