Provider Demographics
NPI:1851955645
Name:VELAZQUEZ, MARIBEL (PT)
Entity Type:Individual
Prefix:MRS
First Name:MARIBEL
Middle Name:
Last Name:VELAZQUEZ
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2135 AVENIDA SANTIAGO DE LOS CABALLEROS
Mailing Address - Street 2:
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00733
Mailing Address - Country:US
Mailing Address - Phone:787-848-4545
Mailing Address - Fax:
Practice Address - Street 1:2135 AVENIDA SANTIAGO DE LOS CABALLEROS
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00733-0949
Practice Address - Country:US
Practice Address - Phone:787-848-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR791225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist