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General NPI Number Information
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NPI Number | 1306956610
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Entity Type | Individual
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Provider Name | MIGUEL VELAZQUEZ-VILLANUEVA MD
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 09/09/2015
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Provider Practice Location Address
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Address Line | 140 AVE LAS CUMBRES SUITE 202 GUAYNABO MEDICAL MALL
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City | GUAYNABO
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State | PR
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Zip | 00969-0000
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Country | US
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Telephone | 787-720-1414
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Fax | 787-287-8811
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Provider Business Mailing Address
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Address Line | PO BOX 19418 FERNANDEZ JUNCOS STATION
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City | SAN JUAN
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State | PR
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Zip | 00910-1418
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Country | US
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Telephone | 787-720-1414
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Fax | 787-287-8811
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 12470
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 2114641
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License Number State | NY
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