Provider Demographics
NPI:1972141133
Name:RIVERA-VELEZ, ELANE (MD)
Entity Type:Individual
Prefix:
First Name:ELANE
Middle Name:
Last Name:RIVERA-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 1:115 URB LA ALBORADA
Mailing Address - Street 2:
Mailing Address - City:SABANA GRANDE
Mailing Address - State:PR
Mailing Address - Zip Code:00637-1567
Mailing Address - Country:US
Mailing Address - Phone:939-491-1744
Mailing Address - Fax:
Practice Address - Street 1:115 URB LA ALBORADA
Practice Address - Street 2:
Practice Address - City:SABANA GRANDE
Practice Address - State:PR
Practice Address - Zip Code:00637-1567
Practice Address - Country:US
Practice Address - Phone:939-491-1744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-18
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22491208D00000X
PR15333I390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program