MEDICARE: DR. EDWIN VELEZ M.D.

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	207P00000X	Emergency Medicine Physician	8430	PR

General Provider Information

NPI Number	:	1407895733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWIN VELEZ M.D.

Provider Business Mailing Address
First Line	:	495 CALLE ALCANFOR
Second Line	:	URB. CIUDAD JARDIN III
City	:	TOA ALTA
State	:	PR
Zip	:	00953-4893
Country	:	US
Telephone Number	:	787-279-8004
Fax Number	:

Provider Business Practice Location Address
First Line	:	495 CALLE ALCANFOR
Second Line	:	URB. CIUDAD JARDIN III
City	:	TOA ALTA
State	:	PR
Zip	:	00953-4893
Country	:	US
Telephone Number	:	787-279-8004
Fax Number	:

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

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	07/24/2015

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