Provider Demographics
NPI:1598024556
Name:VELAZQUEZ, CESAR JUARBE (MS)
Entity Type:Individual
Prefix:
First Name:CESAR
Middle Name:JUARBE
Last Name:VELAZQUEZ
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 CALLE FLORIDA
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-3426
Mailing Address - Country:US
Mailing Address - Phone:787-560-6206
Mailing Address - Fax:
Practice Address - Street 1:CARR 2 KM 112.2
Practice Address - Street 2:BO MORA
Practice Address - City:ISABELA
Practice Address - State:PR
Practice Address - Zip Code:00662
Practice Address - Country:US
Practice Address - Phone:787-560-6206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4059103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist