Provider Demographics
NPI:1336812320
Name:VELEZ OCASIO, JUAN ALEXIS
Entity Type:Individual
Prefix:DR
First Name:JUAN
Middle Name:ALEXIS
Last Name:VELEZ OCASIO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:JARDINES DEL CARIBE
Mailing Address - Street 2:109 CALLE 4
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00728
Mailing Address - Country:US
Mailing Address - Phone:787-449-0405
Mailing Address - Fax:
Practice Address - Street 1:JARDINES DEL CARIBE
Practice Address - Street 2:109 CALLE 4
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00728
Practice Address - Country:US
Practice Address - Phone:787-449-0405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-27
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22441208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice