Provider Demographics
NPI:1689964835
Name:VELEZ, GLORIMIL
Entity Type:Individual
Prefix:PROF
First Name:GLORIMIL
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:CARR 129 KM 1 AVE SAN LUIS
Mailing Address - Street 2:HOSPITAL CAYETANO COLL Y TOSTE
Mailing Address - City:ARECIBO
Mailing Address - State:PR
Mailing Address - Zip Code:00613
Mailing Address - Country:US
Mailing Address - Phone:787-878-7272
Mailing Address - Fax:787-650-7300
Practice Address - Street 1:CARR 129 KM 1 AVE SAN LUIS
Practice Address - Street 2:HOSPITAL CAYETANO COLL Y TOSTE
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00613
Practice Address - Country:US
Practice Address - Phone:787-878-7272
Practice Address - Fax:787-650-7300
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17946172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker