Provider Demographics
NPI:1336143379
Name:VELEZ QUINONES, IRIAMAR (MD)
Entity Type:Individual
Prefix:
First Name:IRIAMAR
Middle Name:
Last Name:VELEZ QUINONES
Suffix:
Gender:F
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 141721
Mailing Address - Street 2:
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00614-1721
Mailing Address - Country:US
Mailing Address - Phone:787-878-3211
Mailing Address - Fax:787-878-3211
Practice Address - Street 1:AVE MIRAMAR NO 517
Practice Address - Street 2:SUITE 2
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612-4371
Practice Address - Country:US
Practice Address - Phone:787-878-3211
Practice Address - Fax:787-878-3211
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14985208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022243Medicare PIN
PRI00202Medicare UPIN