Provider Demographics
NPI:1326035833
Name:RODRIGUEZ-VELEZ, CARLOS (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:RODRIGUEZ-VELEZ
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:PO BOX 63
Mailing Address - Street 2:
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-0063
Mailing Address - Country:US
Mailing Address - Phone:787-267-3056
Mailing Address - Fax:787-267-4223
Practice Address - Street 1:1 CALLE A
Practice Address - Street 2:URB. JARDINES DE BORINQUEN
Practice Address - City:YAUCO
Practice Address - State:PR
Practice Address - Zip Code:00698
Practice Address - Country:US
Practice Address - Phone:787-267-3056
Practice Address - Fax:787-267-4223
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-29
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5432208D00000X, 174400000X, 208D00000X
PR383171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No171100000XOther Service ProvidersAcupuncturist
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRC79334Medicare UPIN
PR0023861Medicare ID - Type Unspecified