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NPI Code Detail

MEDICARE: ILIANA RUIZ VELAZQUEZ MSW

MEDICARE: ILIANA RUIZ VELAZQUEZ MSW
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
11041C0700XClinical Social Worker16404PR

General Provider Information

NPI Number : 1255025607
Entity Type Code : Individual
Provider Name (Legal Business Name) : ILIANA RUIZ VELAZQUEZ MSW
Provider Business Mailing Address
First Line : RR 2 BOX 3043
Second Line :
City : ANASCO
State : PR
Zip : 00610-9395
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10 CALLE CASIA
Second Line :
City : SAN JUAN
State : PR
Zip : 00921-3200
Country : US
Telephone Number : 787-641-7582
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2023
Last Update Date : 05/15/2026

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