Provider Demographics
NPI:1689986895
Name:VELAZQUEZ, BRAULIO CESAR (MD)
Entity Type:Individual
Prefix:DR
First Name:BRAULIO
Middle Name:CESAR
Last Name:VELAZQUEZ
Suffix:
Gender:M
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:COND MANSIONES LOS CAOBOS
Mailing Address - Street 2:APT 17 B AVE SAN PATRICIO J6
Mailing Address - City:GUAYNABO
Mailing Address - State:PR
Mailing Address - Zip Code:00968
Mailing Address - Country:US
Mailing Address - Phone:787-405-2098
Mailing Address - Fax:787-285-1970
Practice Address - Street 1:HUMACAO MEDICAL PLAZA AVE FONT MARTELO 53
Practice Address - Street 2:SUITE 203
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791
Practice Address - Country:US
Practice Address - Phone:787-285-1270
Practice Address - Fax:787-285-1970
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15757208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice