Provider Demographics
NPI:1043540248
Name:VELEZ, SUZETTE MARIE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SUZETTE
Middle Name:MARIE
Last Name:VELEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 4956
Mailing Address - Street 2:PMB 359
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726
Mailing Address - Country:US
Mailing Address - Phone:787-747-2491
Mailing Address - Fax:
Practice Address - Street 1:CARR 3 KM 77.7
Practice Address - Street 2:WALMART PHARMACY
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-656-9410
Practice Address - Fax:787-852-9600
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5365OtherPR PHARMACY LICENCE