Provider Demographics
NPI:1336891001
Name:VELEZ MENDOZA, PEDRO JOSE (MEDICINE DOCTOR)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:JOSE
Last Name:VELEZ MENDOZA
Suffix:
Gender:M
Credentials:MEDICINE DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB CONDADO MODERNO
Mailing Address - Street 2:CALLE8 K6
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-628-8348
Mailing Address - Fax:
Practice Address - Street 1:33 CALLE MUNOZ RIVERA
Practice Address - Street 2:
Practice Address - City:JUNCOS
Practice Address - State:PR
Practice Address - Zip Code:00777-3116
Practice Address - Country:US
Practice Address - Phone:787-713-6801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-24
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23350208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice