Provider Demographics
NPI:1982814455
Name:VELAZQUEZ, AMELIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:AMELIA
Middle Name:
Last Name:VELAZQUEZ
Suffix:
Gender:F
Credentials:DMD
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 7438
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7438
Mailing Address - Country:US
Mailing Address - Phone:787-744-4399
Mailing Address - Fax:
Practice Address - Street 1:AVE LUIS MUNOZ MARIN
Practice Address - Street 2:O-24
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00726
Practice Address - Country:US
Practice Address - Phone:787-744-4399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18351223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics