Provider Demographics
NPI:1497716864
Name:VELEZ DE JESUS LABORATORIES INC.
Entity Type:Organization
Organization Name:VELEZ DE JESUS LABORATORIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:W
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:787-692-1705
Mailing Address - Street 1:PO BOX 4155
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00694-4155
Mailing Address - Country:US
Mailing Address - Phone:787-858-1014
Mailing Address - Fax:787-858-1014
Practice Address - Street 1:72A CALLE BALDORIOTY
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-4337
Practice Address - Country:US
Practice Address - Phone:787-858-1014
Practice Address - Fax:787-858-1014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory