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General NPI Number Information
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NPI Number | 1295702447
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Entity Type | Individual
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Provider Name | WANDA GEORGINA VELEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/07/2006
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Last Update Date | 12/14/2015
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Provider Practice Location Address
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Address Line | 1236 MUNOZ RIVERA AVE. STE. 1
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City | PONCE
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State | PR
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Zip | 00717-0639
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Country | US
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Telephone | 787-844-0895
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Fax | 787-842-2079
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Provider Business Mailing Address
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Address Line | PO BOX 10179
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City | PONCE
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State | PR
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Zip | 00732-0179
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Country | US
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Telephone | 787-844-0895
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Fax | 787-842-2079
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 005882
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License Number State | PR
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