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General NPI Number Information
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NPI Number | 1619141967
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Entity Type | Organization
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Legal Business Name | PONCE HEMATOLOGY ONCOLOGY P.S.C.
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 11/07/2011
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Provider Practice Location Address
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Address Line | 1217 AVE HOSTOS
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City | PONCE
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State | PR
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Zip | 00717-0953
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Country | US
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Telephone | 787-259-7807
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Fax | 787-840-6448
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Provider Business Mailing Address
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Address Line | PO BOX 495
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City | MERCEDITA
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State | PR
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Zip | 00715-0495
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Country | US
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Telephone | 787-259-7807
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Fax | 787-840-6448
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HECTOR ANTONIO VELEZ
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Credential | M.D.
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Telephone | 787-259-7807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0200X
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Taxonomy Name | Oncology Clinic/Center
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License Number | 14795
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License Number State | PR
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