Provider Demographics
NPI:1851963995
Name:SANCHEZ VELEZ, IDALIS MARIE (MD)
Entity Type:Individual
Prefix:
First Name:IDALIS
Middle Name:MARIE
Last Name:SANCHEZ VELEZ
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 1:405 CALLE GUARAGUAO
Mailing Address - Street 2:HACIENDA LA MONSERRATE
Mailing Address - City:MANATI
Mailing Address - State:PR
Mailing Address - Zip Code:00674-6506
Mailing Address - Country:US
Mailing Address - Phone:787-438-0068
Mailing Address - Fax:
Practice Address - Street 1:917 AVE TITO CASTRO
Practice Address - Street 2:
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00716-4717
Practice Address - Country:US
Practice Address - Phone:787-844-2080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-16
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program