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General NPI Number Information
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NPI Number | 1336860329
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Entity Type | Individual
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Provider Name | ELISAMARIE VELEZ PEREZ PA
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Gender | Female
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Dates
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Enumeration Date | 09/07/2022
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | AVE. ROBERTO CLEMENTE ST 66 BLOCK 124 #8 VILLA CAROLINA
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City | CAROLINA
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State | PR
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Zip | 00985
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Country | US
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Telephone | 787-750-6525
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1407
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City | LAJAS
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State | PR
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Zip | 00667-1407
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Country | US
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Telephone | 787-615-7042
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1104-PA
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License Number State | PR
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