Provider Demographics
NPI:1619135126
Name:VELEZ, RAIMUNDO (PHARM D)
Entity Type:Individual
Prefix:
First Name:RAIMUNDO
Middle Name:
Last Name:VELEZ
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 401
Mailing Address - Street 2:
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00605-0401
Mailing Address - Country:US
Mailing Address - Phone:787-587-8742
Mailing Address - Fax:
Practice Address - Street 1:GAUTIER BENITEZ AVE
Practice Address - Street 2:PLAZA DEL CARMEN MALL
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-743-1273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5231183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR5231OtherPUERTO RICO STATE LICENSE