Healthcare Provider Details

I. General information

NPI: 1386600724
Provider Name (Legal Business Name): ROBERTO VELEZ ECHEVARRIA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 07/20/2020
Certification Date: 07/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 AVE HOSTOS SUITE 204
MAYAGUEZ PR
00682-1538
US

IV. Provider business mailing address

PO BOX 467
MAYAGUEZ PR
00681-0467
US

V. Phone/Fax

Practice location:
  • Phone: 787-834-6161
  • Fax: 787-805-3715
Mailing address:
  • Phone: 787-344-6637
  • Fax: 787-805-3715

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number10391
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: