MEDICARE: DR. ZELIDEH CORDOVA-VELAZCO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170100000X	Ph.D. Medical Genetics	4865	PR

General Provider Information

NPI Number	:	1033159967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZELIDEH CORDOVA-VELAZCO M.D.

Provider Business Mailing Address
First Line	:	K1 DELONIX ST
Second Line	:	HACIENDA DEL DORADO
City	:	TOA ALTA
State	:	PR
Zip	:	00949
Country	:	US
Telephone Number	:	787-346-4281
Fax Number	:

Provider Business Practice Location Address
First Line	:	K1 DELONIX ST
Second Line	:	HACIENDA DEL DORADO
City	:	TOA ALTA
State	:	PR
Zip	:	00949
Country	:	US
Telephone Number	:	787-346-4281
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	03/04/2016

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