Provider Demographics
NPI:1396085767
Name:ROSARIO VELAZQUEZ, CORP
Entity type:Organization
Organization Name:ROSARIO VELAZQUEZ, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:LEONOR
Authorized Official - Last Name:ROSARIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-650-3301
Mailing Address - Street 1:HC 2 BOX 5656
Mailing Address - Street 2:
Mailing Address - City:BAJADERO
Mailing Address - State:PR
Mailing Address - Zip Code:00616
Mailing Address - Country:US
Mailing Address - Phone:787-650-3301
Mailing Address - Fax:
Practice Address - Street 1:CARR. 638 KM. 6.0
Practice Address - Street 2:BARRIO MIRAFLORES
Practice Address - City:ARECIBO
Practice Address - State:PR
Practice Address - Zip Code:00612
Practice Address - Country:US
Practice Address - Phone:787-650-3301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-22
Last Update Date:2013-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR14-F-3089333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy