Provider Demographics
NPI:1124362256
Name:VELAZQUEZ-FERNANDEZ, ANGEL MANUEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGEL
Middle Name:MANUEL
Last Name:VELAZQUEZ-FERNANDEZ
Suffix:
Gender:M
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:VENTANAS AL VALLE
Mailing Address - Street 2:APT 216
Mailing Address - City:GURABO
Mailing Address - State:PR
Mailing Address - Zip Code:00778
Mailing Address - Country:US
Mailing Address - Phone:787-934-7718
Mailing Address - Fax:
Practice Address - Street 1:O24 AVE LUIS MUNOZ MARIN
Practice Address - Street 2:
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-6162
Practice Address - Country:US
Practice Address - Phone:787-744-4399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2015-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR29201R208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics