MEDICARE: FAMILY & OB GYN HEALTH CARE

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	207V00000X	Obstetrics & Gynecology Physician	7539	PR

General Provider Information

NPI Number	:	1467866970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY & OB GYN HEALTH CARE

Provider Business Mailing Address
First Line	:	A19 CALLE 1
Second Line	:	VILLAS DE LEVITOWN
City	:	TOA BAJA
State	:	PR
Zip	:	00949-4275
Country	:	US
Telephone Number	:	787-526-3389
Fax Number	:	787-784-6667

Provider Business Practice Location Address
First Line	:	112 CALLE ARZUAGA
Second Line	:	SUIT 606 CONDOMINIO MEDINA CENTER
City	:	RIO PIEDRAS
State	:	PR
Zip	:	00925-3321
Country	:	US
Telephone Number	:	787-764-8296
Fax Number	:	787-764-8296

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JESUS VELEZ FELICIANO
Credential	:	MD
Telephone Number	:	787-526-3389

Provider Enumeration Date	:	06/12/2014
Last Update Date	:	06/12/2014

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