Healthcare Provider Details

I. General information

NPI: 1932178837
Provider Name (Legal Business Name): ZENAIDA IVETTE QUINONES VELEZ PT, DPT, CCVT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CALLE PERAL 29 NORTE AL COSTADO DEL TERMINAR DE CARROS PUBLICOS
MAYAGUEZ PR
00680
US

IV. Provider business mailing address

PO BOX 65
MAYAGUEZ PR
00681-0065
US

V. Phone/Fax

Practice location:
  • Phone: 787-834-3536
  • Fax: 787-834-3536
Mailing address:
  • Phone: 787-834-3536
  • Fax: 787-834-3536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number732
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number732
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: