Provider Demographics
NPI:1407877863
Name:VELEZ, SHARON (LCDA)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:VELEZ
Suffix:
Gender:F
Credentials:LCDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 CALLE JAZMIN
Mailing Address - Street 2:HACIENDA FLORIDA
Mailing Address - City:YAUCO
Mailing Address - State:PR
Mailing Address - Zip Code:00698-4543
Mailing Address - Country:US
Mailing Address - Phone:787-267-3182
Mailing Address - Fax:
Practice Address - Street 1:16 CALLE FRANCISCO M QUINONEZ
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-1945
Practice Address - Country:US
Practice Address - Phone:787-873-0198
Practice Address - Fax:787-873-3166
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4720183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist