Provider Demographics
NPI:1235490301
Name:PELAEZ, DANIEL (MSW)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:PELAEZ
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 CALLE ORQUIDEA
Mailing Address - Street 2:ROUND HILL
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-2713
Mailing Address - Country:US
Mailing Address - Phone:787-599-1359
Mailing Address - Fax:
Practice Address - Street 1:10 CASIA STREET
Practice Address - Street 2:VETERANS HOSPITAL
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00921
Practice Address - Country:US
Practice Address - Phone:787-641-7582
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR87121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical