Provider Demographics
NPI:1417178898
Name:VELEZ-RUIZ, THAYLLIN
Entity Type:Individual
Prefix:DR
First Name:THAYLLIN
Middle Name:
Last Name:VELEZ-RUIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 CALLE SAUCE
Mailing Address - Street 2:URB EL VALLE
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-2523
Mailing Address - Country:US
Mailing Address - Phone:787-923-3748
Mailing Address - Fax:787-831-4239
Practice Address - Street 1:410 AVE HOSTOS
Practice Address - Street 2:SUITE 7
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1560
Practice Address - Country:US
Practice Address - Phone:787-832-6771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13984208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice