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General NPI Number Information
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NPI Number | 1689986895
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Entity Type | Individual
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Provider Name | BRAULIO CESAR VELAZQUEZ M.D
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Gender | Male
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Dates
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Enumeration Date | 07/06/2010
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Last Update Date | 07/06/2010
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Provider Practice Location Address
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Address Line | HUMACAO MEDICAL PLAZA AVE FONT MARTELO 53 SUITE 203
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City | HUMACAO
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State | PR
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Zip | 00791
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Country | US
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Telephone | 787-285-1270
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Fax | 787-285-1970
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Provider Business Mailing Address
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Address Line | COND MANSIONES LOS CAOBOS APT 17 B AVE SAN PATRICIO J6
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City | GUAYNABO
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State | PR
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Zip | 00968
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Country | US
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Telephone | 787-405-2098
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Fax | 787-285-1970
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 15757
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License Number State | PR
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