Provider Demographics
NPI:1043229834
Name:VELEZ GARCIA, IRIS VANESA (MD)
Entity Type:Individual
Prefix:DR
First Name:IRIS
Middle Name:VANESA
Last Name:VELEZ GARCIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 801149
Mailing Address - Street 2:
Mailing Address - City:COTO LAUREL
Mailing Address - State:PR
Mailing Address - Zip Code:00780-1149
Mailing Address - Country:US
Mailing Address - Phone:787-840-0384
Mailing Address - Fax:
Practice Address - Street 1:1034 AVE HOSTOS
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-1115
Practice Address - Country:US
Practice Address - Phone:787-843-9393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR12052207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRG41008Medicare UPIN
PR008-8583Medicare ID - Type Unspecified