Provider Demographics
NPI:1588622674
Name:VELAZQUEZ TORRES, ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:VELAZQUEZ TORRES
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:EDIFICIO PORRATA PILA 2431 AVE LAS AMERICAS
Mailing Address - Street 2:SUITE 105
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00717-2114
Mailing Address - Country:US
Mailing Address - Phone:787-841-0587
Mailing Address - Fax:787-842-2952
Practice Address - Street 1:EDIFICIO PORRATA PILA 2431 AVE LAS AMERICAS
Practice Address - Street 2:SUITE 105
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00717-2114
Practice Address - Country:US
Practice Address - Phone:787-841-0587
Practice Address - Fax:787-842-2952
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7161207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR28238Medicare ID - Type Unspecified
PRF01251Medicare UPIN