Provider Demographics
NPI:1689603946
Name:VELAZQUEZ-SALICRUP, MARIA ISABEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:ISABEL
Last Name:VELAZQUEZ-SALICRUP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. HILLSIDE
Mailing Address - Street 2:A 11 CALLE 1
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926
Mailing Address - Country:US
Mailing Address - Phone:787-373-1073
Mailing Address - Fax:787-373-1073
Practice Address - Street 1:CENTRO DE DIAGNOSTICO Y TRATAMIENTO ( CDT)
Practice Address - Street 2:CALLE BARCELO # 12
Practice Address - City:CIDRA
Practice Address - State:PR
Practice Address - Zip Code:00739
Practice Address - Country:US
Practice Address - Phone:787-739-2059
Practice Address - Fax:787-739-2059
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR04029261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty