Provider Demographics
NPI:1912537416
Name:RODRIGUEZ VELEZ, BETZAIDA (DR)
Entity Type:Individual
Prefix:
First Name:BETZAIDA
Middle Name:
Last Name:RODRIGUEZ VELEZ
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SECT ZAMOT
Mailing Address - Street 2:
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662-3415
Mailing Address - Country:US
Mailing Address - Phone:787-342-8622
Mailing Address - Fax:
Practice Address - Street 1:BO COLOMBIA
Practice Address - Street 2:CALLE RELAMPAGO #70
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680
Practice Address - Country:US
Practice Address - Phone:787-342-8622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6569103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical