MEDICARE: DR. MERCEDES VELAZQUEZ MD

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	2084P0800X	Psychiatry Physician	09222	PR

General Provider Information

NPI Number	:	1154382133
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MERCEDES VELAZQUEZ MD

Provider Business Mailing Address
First Line	:	1804 EDUARDO CONDE AVE
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00912
Country	:	US
Telephone Number	:	787-292-1490
Fax Number	:	787-293-0065

Provider Business Practice Location Address
First Line	:	CARR. 844 KM.O.9 CAMINO LOS PIZARROS
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00926-5230
Country	:	US
Telephone Number	:	787-292-1490
Fax Number	:	787-293-0065

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

Provider Enumeration Date	:	03/30/2006
Last Update Date	:	08/11/2018

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