Healthcare Provider Details

I. General information

NPI: 1932656063
Provider Name (Legal Business Name): MARCOS J VELEZ PHARMACY TECH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2016
Last Update Date: 09/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 O MCKINLEY ST
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

114 O MCKINLEY ST
MAYAGUEZ PUERTO RICO
00680
UM

V. Phone/Fax

Practice location:
  • Phone: 787-265-3330
  • Fax: 787-834-9408
Mailing address:
  • Phone: 787-265-3330
  • Fax: 787-834-9408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number8757
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: