Healthcare Provider Details
I. General information
NPI: 1326038423
Provider Name (Legal Business Name): ZUNILDA VELEZ RIVERA DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/28/2005
Last Update Date: 01/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
EDIFICIO MARVESA 472 AVE TITO CASTRO STE 405
PONCE PR
00716
US
IV. Provider business mailing address
PO BOX 7575
PONCE PR
00732-7575
US
V. Phone/Fax
- Phone: 787-848-6221
- Fax: 787-848-6221
- Phone: 787-848-6221
- Fax: 787-848-6221
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213E00000X |
| Taxonomy | Podiatrist |
| License Number | 0065 |
| License Number State | PR |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: