Provider Demographics
NPI:1013305028
Name:VELEZ ZAYAS, MELISSA (LND)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:VELEZ ZAYAS
Suffix:
Gender:F
Credentials:LND
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 1061
Mailing Address - Street 2:
Mailing Address - City:BARRANQUITAS
Mailing Address - State:PR
Mailing Address - Zip Code:00794-1061
Mailing Address - Country:US
Mailing Address - Phone:787-487-9142
Mailing Address - Fax:
Practice Address - Street 1:CARR. 891 KM 0.1 SUITE 1 VILLA ORO PLAZA
Practice Address - Street 2:
Practice Address - City:COROZAL
Practice Address - State:PR
Practice Address - Zip Code:00783
Practice Address - Country:US
Practice Address - Phone:787-617-8141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-26
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1877133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered