Healthcare Provider Details

I. General information

NPI: 1295285757
Provider Name (Legal Business Name): JOSE GABRIEL RODRIGUEZ VELEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2016
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 AVE TITO CASTRO STE 715
PONCE PR
00716-4722
US

IV. Provider business mailing address

URB REPTO ANAIDA D11 CALLE ECLIPSE
PONCE PR
00716
US

V. Phone/Fax

Practice location:
  • Phone: 787-290-5577
  • Fax:
Mailing address:
  • Phone: 787-678-2285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number21396
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number21396
License Number StatePR
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number21396
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: