MEDICARE: DR. HERNAN J. VELEZ-JUAN

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	888	PR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	888	OTHER	PR	STATE LICENSE NUMBER

General Provider Information

NPI Number	:	1033224043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HERNAN J. VELEZ-JUAN

Provider Business Mailing Address
First Line	:	1845 CARR. #2
Second Line	:	BAYAMON MEDICAL PLAZA SUITE 801
City	:	BAYAMON
State	:	PR
Zip	:	00959-7206
Country	:	US
Telephone Number	:	787-786-0025
Fax Number	:	787-786-0060

Provider Business Practice Location Address
First Line	:	1845 CARR. #2
Second Line	:	BAYAMON MEDICAL PLAZA SUITE 801
City	:	BAYAMON
State	:	PR
Zip	:	00959-7206
Country	:	US
Telephone Number	:	787-786-0025
Fax Number	:	787-786-0060

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

Provider Enumeration Date	:	08/20/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. HERNAN J. VELEZ-JUAN ” Practice Location

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