Provider Demographics
NPI:1649755802
Name:VELEZ RIVERA, JOANA A
Entity Type:Individual
Prefix:
First Name:JOANA
Middle Name:A
Last Name:VELEZ RIVERA
Suffix:
Gender:F
Credentials:
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 193069
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00919-3069
Mailing Address - Country:US
Mailing Address - Phone:787-761-0036
Mailing Address - Fax:787-292-5050
Practice Address - Street 1:150 AVE DE DIEGO
Practice Address - Street 2:EDIF SAN JUAN HEALTH CENTER
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-0090
Practice Address - Country:US
Practice Address - Phone:787-724-4333
Practice Address - Fax:787-292-5050
Is Sole Proprietor?:No
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4288235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist