Healthcare Provider Details

I. General information

NPI: 1346053691
Provider Name (Legal Business Name): ANGELICA M VELEZ BOBE RDN, LND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2025
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

E653 C 9 URB CONSTANCIA
PONCE PR
00717-0759
US

IV. Provider business mailing address

122 CALLE EL YAGRUMO URB VALLE HUCARES
JUANA DIAZ PR
00795-2814
US

V. Phone/Fax

Practice location:
  • Phone: 787-484-0203
  • Fax:
Mailing address:
  • Phone: 787-484-0203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1501X
TaxonomySports Dietetics Nutrition Registered Dietitian
License Number002244
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number002244
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: