Healthcare Provider Details

I. General information

NPI: 1851963995
Provider Name (Legal Business Name): IDALIS MARIE SANCHEZ VELEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2021
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

917 AVE TITO CASTRO
PONCE PR
00716-4717
US

IV. Provider business mailing address

405 CALLE GUARAGUAO HACIENDA LA MONSERRATE
MANATI PR
00674-6506
US

V. Phone/Fax

Practice location:
  • Phone: 787-844-2080
  • Fax:
Mailing address:
  • Phone: 787-438-0068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number23247
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: