Provider Demographics
NPI:1457891939
Name:VELAZQUEZ-GONZALEZ, HECTOR JOSE (PHD)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:JOSE
Last Name:VELAZQUEZ-GONZALEZ
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5838 CALLE ARADO
Mailing Address - Street 2:HACIENDA LA MATILDE
Mailing Address - City:PONCE
Mailing Address - State:PR
Mailing Address - Zip Code:00724-2453
Mailing Address - Country:US
Mailing Address - Phone:787-678-2735
Mailing Address - Fax:
Practice Address - Street 1:5838 CALLE ARADO
Practice Address - Street 2:HACIENDA LA MATILDE
Practice Address - City:PONCE
Practice Address - State:PR
Practice Address - Zip Code:00724-2453
Practice Address - Country:US
Practice Address - Phone:787-678-2735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-02
Last Update Date:2017-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR5889103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist