Provider Demographics
NPI:1689210767
Name:BURGOS VELEZ, SOLEIL MAR (PHARMD)
Entity Type:Individual
Prefix:
First Name:SOLEIL
Middle Name:MAR
Last Name:BURGOS VELEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 AVE FELISA RINCON
Mailing Address - Street 2:
Mailing Address - City:VEGA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00693-3375
Mailing Address - Country:US
Mailing Address - Phone:787-685-0680
Mailing Address - Fax:
Practice Address - Street 1:457 AVE FELISA RINCON
Practice Address - Street 2:
Practice Address - City:VEGA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00693-3375
Practice Address - Country:US
Practice Address - Phone:787-685-0680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-23
Last Update Date:2019-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist