Provider Demographics
NPI:1902002777
Name:VELEZ LAGO, FRANCES MARIE (MD)
Entity Type:Individual
Prefix:MISS
First Name:FRANCES
Middle Name:MARIE
Last Name:VELEZ LAGO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:AVE. LUIS MUNOZ MARIN 100
Mailing Address - Street 2:HIMA MEDICAL CLINIC STE 308
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-961-4696
Mailing Address - Fax:
Practice Address - Street 1:AVE LUIS MUNOZ MARIN 100
Practice Address - Street 2:HIMA MEDICAL CLINIC STE 308
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-961-4696
Practice Address - Fax:787-961-4653
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR171062084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRFG596AMedicare UPIN