MEDICARE: DR. ANA A. TAVAREZ VELEZ PSY. 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	103TC0700X	Clinical Psychologist	103TC0700X2914	PR

General Provider Information

NPI Number	:	1437348372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANA A. TAVAREZ VELEZ PSY. D.

Provider Business Mailing Address
First Line	:	URB. CAMPO LAGO 50 PALMAS
Second Line	:
City	:	CIDRA
State	:	PR
Zip	:	00739-9360
Country	:	US
Telephone Number	:	787-595-2225
Fax Number	:	787-739-3954

Provider Business Practice Location Address
First Line	:	68 CALLE AQUAMARINA
Second Line	:	URB. VILLA BLANCA
City	:	CAGUAS
State	:	PR
Zip	:	00725-1908
Country	:	US
Telephone Number	:	787-595-2225
Fax Number	:	787-739-3954

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

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	06/09/2016

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