Provider Demographics
NPI:1811618077
Name:SV GASTROENTEROLOGY LLC
Entity type:Organization
Organization Name:SV GASTROENTEROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:JANICE
Authorized Official - Last Name:VELAZQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-475-0388
Mailing Address - Street 1:URB. OLYMPIC COURT
Mailing Address - Street 2:153-A4 CALLE ANTIOQUIA
Mailing Address - City:LAS PIEDRAS
Mailing Address - State:PR
Mailing Address - Zip Code:00771-0001
Mailing Address - Country:US
Mailing Address - Phone:787-475-0388
Mailing Address - Fax:
Practice Address - Street 1:874 FERNANDEZ JUNCOS AVENUE
Practice Address - Street 2:EDIFICIO JESUS T PINEIRO
Practice Address - City:CAROLINA
Practice Address - State:PR
Practice Address - Zip Code:00979-0001
Practice Address - Country:US
Practice Address - Phone:787-626-3322
Practice Address - Fax:787-626-0472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-07
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty