Healthcare Provider Details

I. General information

NPI: 1427112143
Provider Name (Legal Business Name): LUIS R CUEBAS VELEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 11/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CALLE DE DIEGO E
MAYAGUEZ PR
00680-4864
US

IV. Provider business mailing address

PO BOX 4173
MAYAGUEZ PR
00681-4173
US

V. Phone/Fax

Practice location:
  • Phone: 787-834-3679
  • Fax:
Mailing address:
  • Phone: 787-834-3679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number6401
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: