Provider Demographics
NPI:1689744153
Name:VELEZ, IRIS D
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:D
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:EDIF C-66 APT. 343
Mailing Address - Street 2:CONDOMINIO LOS NARANJALES
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00985
Mailing Address - Country:US
Mailing Address - Phone:787-637-5021
Mailing Address - Fax:
Practice Address - Street 1:EDIF C-66 APT. 343
Practice Address - Street 2:CONDOMINIO LOS NARANJALES
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00985
Practice Address - Country:US
Practice Address - Phone:787-637-5021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5362183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician