Healthcare Provider Details

I. General information

NPI: 1770685026
Provider Name (Legal Business Name): JESUS VELEZ-FELICIANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 01/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 CALLE ARZUAGA CONDOMINIO MEDINA CENTER OF 606
SAN JUAN PR
00925-3321
US

IV. Provider business mailing address

CALLE 1 A 19 VILLAS DE LEVITTON
TOA BAJA PR
00949-4902
US

V. Phone/Fax

Practice location:
  • Phone: 787-764-8296
  • Fax: 787-764-8296
Mailing address:
  • Phone: 787-261-4589
  • Fax: 787-261-4589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number7539
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: