Healthcare Provider Details

I. General information

NPI: 1770444630
Provider Name (Legal Business Name): PVC MEDICAL GI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2025
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

576 AVE ARTERIAL B APT 803
SAN JUAN PR
00918-2223
US

IV. Provider business mailing address

576 AVE ARTERIAL B APT 803
SAN JUAN PR
00918-2223
US

V. Phone/Fax

Practice location:
  • Phone: 787-638-2248
  • Fax:
Mailing address:
  • Phone: 787-638-2248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PALOMA M VELASCO CORRADA
Title or Position: OWNER
Credential: MD
Phone: 787-638-2248