Provider Demographics
NPI:1598046302
Name:VELEZ, BRAULIO M (PHD, CCRET)
Entity Type:Individual
Prefix:DR
First Name:BRAULIO
Middle Name:M
Last Name:VELEZ
Suffix:
Gender:M
Credentials:PHD, CCRET
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 CALLE A
Mailing Address - Street 2:URB. VICTOR ROJAS 2
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00612
Mailing Address - Country:US
Mailing Address - Phone:787-422-9521
Mailing Address - Fax:
Practice Address - Street 1:255 CALLE A
Practice Address - Street 2:URB. VICTOR ROJAS 2
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-422-9521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-07
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0712102328OtherIACT