Healthcare Provider Details

I. General information

NPI: 1386966174
Provider Name (Legal Business Name): DAVID VELEZ REGISTER NURSE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: DAVID VELEZ MASTER SCIENCE NURSE

II. Dates (important events)

Enumeration Date: 02/19/2010
Last Update Date: 02/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

871 CALLE E DE IRIZARRY URBANIZACION VILLA SULTANITA
MAYAGUEZ PR
00680-7030
US

IV. Provider business mailing address

871 CALLE E DE IRIZARRY URBANIZACION VILLA SULTANITA
MAYAGUEZ PR
00680-7030
US

V. Phone/Fax

Practice location:
  • Phone: 787-217-7630
  • Fax:
Mailing address:
  • Phone: 787-217-7630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number13051
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number306
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: