Provider Demographics
NPI:1629715479
Name:EVF MEDICAL SERVICE INC
Entity Type:Organization
Organization Name:EVF MEDICAL SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELBA
Authorized Official - Middle Name:
Authorized Official - Last Name:VELAZQUEZ FRATICELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-836-8522
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:PENUELAS
Mailing Address - State:PR
Mailing Address - Zip Code:00624-0068
Mailing Address - Country:US
Mailing Address - Phone:787-836-8522
Mailing Address - Fax:787-836-8522
Practice Address - Street 1:959 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:PENUELAS
Practice Address - State:PR
Practice Address - Zip Code:00624-1401
Practice Address - Country:US
Practice Address - Phone:787-836-8522
Practice Address - Fax:787-836-8522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty