Provider Demographics
NPI:1407895733
Name:VELEZ, EDWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:
Last Name: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 1:495 CALLE ALCANFOR
Mailing Address - Street 2:URB. CIUDAD JARDIN III
Mailing Address - City:TOA ALTA
Mailing Address - State:PR
Mailing Address - Zip Code:00953-4893
Mailing Address - Country:US
Mailing Address - Phone:787-279-8004
Mailing Address - Fax:
Practice Address - Street 1:495 CALLE ALCANFOR
Practice Address - Street 2:URB. CIUDAD JARDIN III
Practice Address - City:TOA ALTA
Practice Address - State:PR
Practice Address - Zip Code:00953-4893
Practice Address - Country:US
Practice Address - Phone:787-279-8004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2015-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8430207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRF21414Medicare UPIN
PR0081148Medicare ID - Type Unspecified