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General NPI Number Information
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NPI Number | 1982410734
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Entity Type | Organization
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Legal Business Name | IVAN FRANCISCO VELEZ MONTERO
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | CARR. 111 KM 51.7 BO. CAGUANA
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City | UTUADO
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State | PR
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Zip | 00641
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Country | US
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Telephone | 939-488-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 15 COLINAS DE SAN ANDRES
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City | UTUADO
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State | PR
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Zip | 00641-9709
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Country | US
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Telephone | 787-378-0676
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | IVAN FRANCISCO VELEZ
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Credential |
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Telephone | 787-378-0676
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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