MEDICARE: ROBERTO VELEZ ECHEVARRIA 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	208000000X	Pediatrics Physician	10391	PR

General Provider Information

NPI Number	:	1386600724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERTO VELEZ ECHEVARRIA MD

Provider Business Mailing Address
First Line	:	PO BOX 467
Second Line	:
City	:	MAYAGUEZ
State	:	PR
Zip	:	00681-0467
Country	:	US
Telephone Number	:	787-344-6637
Fax Number	:	787-805-3715

Provider Business Practice Location Address
First Line	:	770 AVE HOSTOS
Second Line	:	SUITE 204
City	:	MAYAGUEZ
State	:	PR
Zip	:	00682-1538
Country	:	US
Telephone Number	:	787-834-6161
Fax Number	:	787-805-3715

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

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	07/20/2020

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