Provider Demographics
NPI:1205854569
Name:VELAZQUEZ, JOHN NELSON (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:NELSON
Last Name:VELAZQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:STREET 7 H 4
Mailing Address - Street 2:URB. PASEO ALTA VISTA
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953
Mailing Address - Country:US
Mailing Address - Phone:787-730-7435
Mailing Address - Fax:787-203-5029
Practice Address - Street 1:STREET 7 H 4
Practice Address - Street 2:URB. PASEO ALTA VISTA
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-0000
Practice Address - Country:US
Practice Address - Phone:787-730-7435
Practice Address - Fax:787-203-5029
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR15213208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022588Medicare ID - Type UnspecifiedGENERAL MEDICIN