=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528915071
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NUCLEAR IMAGING & MEDICINE PR LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2026
-----------------------------------------------------
Last Update Date | 03/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | CARR. 21 NUM 1785 AVE. LAS LOMAS #21 HOSPITAL METROPOLITANO
-----------------------------------------------------
City | SAN JUAN
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-782-9999
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 444 CAMINO DE GUAJATACA
-----------------------------------------------------
City | DORADO
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00646-3637
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-528-6332
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. IVAN F VELEZ-MIRO
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 787-528-6332
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207UN0902X
-----------------------------------------------------
Taxonomy Name | Nuclear Imaging & Therapy Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207U00000X
-----------------------------------------------------
Taxonomy Name | Nuclear Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------