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General NPI Number Information
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NPI Number | 1669462651
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Entity Type | Individual
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Provider Name | WILFREDO VELAZQUEZ CAPO MD
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Gender | Male
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Dates
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Enumeration Date | 10/21/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | EDIFIO RODVAL, CALLE SAN MARTIN CARR 2, KM 4.9, BUCHANAN
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City | GUANABO
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State | PR
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Zip | 00968
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Country | US
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Telephone | 787-775-1200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 34070
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City | FORT BUCHANAN
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State | PR
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Zip | 00934-0070
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Country | US
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Telephone | 787-775-7200
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Fax | 787-775-1202
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4296
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License Number State | PR
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