MEDICARE: RV MEDICAL MANAGEMENT LLC

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1306622162
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RV MEDICAL MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	PO BOX 371352
Second Line	:
City	:	CAYEY
State	:	PR
Zip	:	00737-1352
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 CALLE HERADIO MENDOZA ESTE
Second Line	:
City	:	CAYEY
State	:	PR
Zip	:	00736-3801
Country	:	US
Telephone Number	:	619-354-0553
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ROBBY J VELEZ
Credential	:	MD
Telephone Number	:	619-354-0553

Provider Enumeration Date	:	09/06/2023
Last Update Date	:	09/06/2023

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