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General NPI Number Information
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NPI Number | 1538976097
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Entity Type | Individual
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Provider Name | SULLY VELEZ RDN
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Gender | Female
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Dates
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Enumeration Date | 12/17/2024
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Last Update Date | 12/17/2024
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Provider Practice Location Address
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Address Line | B7 CALLE SANTA CRUZ
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City | BAYAMON
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State | PR
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Zip | 00961-6902
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Country | US
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Telephone | 787-625-6111
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Fax |
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Provider Business Mailing Address
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Address Line | CALLE ONIX U-13 VALLE CERRO GORDO
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City | BAYAMON
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State | PR
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Zip | 00961-6902
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Country | US
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Telephone |
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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 | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | 1615
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License Number State | PR
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