Healthcare Provider Details

I. General information

NPI: 1205720612
Provider Name (Legal Business Name): LOURDES MARGARITA VELEZ ORTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BO. TIERRAS NUEVAS SECT. LOS RABANOS CARR. 604 KM. 3.8
MANATI PR
00674
US

IV. Provider business mailing address

BO. TIERRAS NUEVAS SECT. LOS RABANOS CARR. 604 KM. 3.8
MANATI PR
00674
US

V. Phone/Fax

Practice location:
  • Phone: 787-373-8954
  • Fax:
Mailing address:
  • Phone: 787-373-8954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number007334
License Number StatePR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: