Provider Demographics
NPI:1922255876
Name:CASTRO VELEZ, LUIS A (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:A
Last Name:CASTRO VELEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LUIS
Other - Middle Name:A
Other - Last Name:CASTRO VELEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PARQUE MONTEBELLO
Mailing Address - Street 2:F20 CALLE 2
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976-2868
Mailing Address - Country:US
Mailing Address - Phone:787-550-6162
Mailing Address - Fax:
Practice Address - Street 1:CENTRO INTERNACIONAL DE MERCADEO
Practice Address - Street 2:SUITE 303 AVE. LOS CANOS EXQ 28 KM 0.0
Practice Address - City:GUAYNABO
Practice Address - State:PR
Practice Address - Zip Code:00968-0001
Practice Address - Country:US
Practice Address - Phone:787-277-0847
Practice Address - Fax:787-277-0942
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR27631 R208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation