Provider Demographics
NPI:1942451935
Name:VELEZ PEREZ, OMAYRA
Entity Type:Individual
Prefix:
First Name:OMAYRA
Middle Name:
Last Name:VELEZ PEREZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 894
Mailing Address - Street 2:
Mailing Address - City:QUEBRADILLAS
Mailing Address - State:PR
Mailing Address - Zip Code:00678-0894
Mailing Address - Country:US
Mailing Address - Phone:787-895-4203
Mailing Address - Fax:787-895-4203
Practice Address - Street 1:ROAD 113
Practice Address - Street 2:KM 13.6
Practice Address - City:QUEBRADILLAS
Practice Address - State:PR
Practice Address - Zip Code:00678-0894
Practice Address - Country:US
Practice Address - Phone:787-895-4203
Practice Address - Fax:787-895-4203
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2013-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1168291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory