Provider Demographics
NPI:1043679624
Name:VELEZ, LESLY ANN I
Entity Type:Individual
Prefix:MS
First Name:LESLY
Middle Name:ANN
Last Name:VELEZ
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 CALLE ARGENTINA
Mailing Address - Street 2:COM. LA DOLORES
Mailing Address - City:RIO GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00745-2306
Mailing Address - Country:US
Mailing Address - Phone:787-614-2464
Mailing Address - Fax:
Practice Address - Street 1:2019 AVE BORINQUEN
Practice Address - Street 2:BARRIO OBRERO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00915-3813
Practice Address - Country:US
Practice Address - Phone:787-726-7558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-11
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR9592183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician