MEDICARE: PVC MEDICAL GI 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	207RG0100X	Gastroenterology Physician

General Provider Information

NPI Number	:	1770444630
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PVC MEDICAL GI LLC

Provider Business Mailing Address
First Line	:	576 AVE ARTERIAL B APT 803
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-2223
Country	:	US
Telephone Number	:	787-638-2248
Fax Number	:

Provider Business Practice Location Address
First Line	:	576 AVE ARTERIAL B APT 803
Second Line	:
City	:	SAN JUAN
State	:	PR
Zip	:	00918-2223
Country	:	US
Telephone Number	:	787-638-2248
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. PALOMA M VELASCO CORRADA
Credential	:	MD
Telephone Number	:	787-638-2248

Provider Enumeration Date	:	11/20/2025
Last Update Date	:	07/01/2026

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