MEDICARE: NEREIDA VELEZ DURAN M.S

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	235Z00000X	Speech-Language Pathologist	190	PR

General Provider Information

NPI Number	:	1154452340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEREIDA VELEZ DURAN M.S

Provider Business Mailing Address
First Line	:	22 CALLE SERENIDAD
Second Line	:	PARAISO DE MAYAGUEZ
City	:	MAYAGUEZ
State	:	PR
Zip	:	00680-6201
Country	:	US
Telephone Number	:	787-380-0589
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 AVE HOSTOS
Second Line	:	SUITE 15
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-1560
Country	:	US
Telephone Number	:	787-832-7355
Fax Number	:

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

Provider Enumeration Date	:	03/08/2007
Last Update Date	:	07/08/2007

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Directions to “ NEREIDA VELEZ DURAN M.S” Practice Location

Language	Start Address	Practice Location

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