Healthcare Provider Details

I. General information

NPI: 1972141133
Provider Name (Legal Business Name): ELANE RIVERA-VELEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2019
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 CALLE MUNOZ RIVERA W
RINCON PR
00677-2127
US

IV. Provider business mailing address

115 URB LA ALBORADA
SABANA GRANDE PR
00637-1567
US

V. Phone/Fax

Practice location:
  • Phone: 787-823-5500
  • Fax: 787-823-2990
Mailing address:
  • Phone: 939-491-1744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number15333I
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number22491
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: