Provider Demographics
NPI:1497712392
Name:VELAZQUEZ, SONIA E (MD)
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:E
Last Name:VELAZQUEZ
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 1:359 DE DIEGO AVE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00909-1738
Mailing Address - Country:US
Mailing Address - Phone:787-722-0445
Mailing Address - Fax:787-723-4415
Practice Address - Street 1:359 DE DIEGO AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00909-1738
Practice Address - Country:US
Practice Address - Phone:787-722-0445
Practice Address - Fax:787-723-4415
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR10456207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRE43315Medicare UPIN