Provider Demographics
NPI:1659748408
Name:VELEZ, SANDRA
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:VELEZ
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:CALLE LUIS MUNOZ RIVERA 49
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PUERTO RICO
Mailing Address - Zip Code:00637
Mailing Address - Country:UM
Mailing Address - Phone:787-543-1787
Mailing Address - Fax:
Practice Address - Street 1:3 CALLE ANGEL G MARTINEZ
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-1914
Practice Address - Country:US
Practice Address - Phone:939-910-7920
Practice Address - Fax:939-910-7921
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR4433183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician