Provider Demographics
NPI:1932333572
Name:VELAZQUEZ, CARLOS ARTURO (LICENSED PSYCHOLOGIS)
Entity Type:Individual
Prefix:PROF
First Name:CARLOS
Middle Name:ARTURO
Last Name:VELAZQUEZ
Suffix:
Gender:M
Credentials:LICENSED PSYCHOLOGIS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:# 416 PONCE DE LEON AVENUE
Mailing Address - Street 2:SUITE. 1511
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918-3423
Mailing Address - Country:US
Mailing Address - Phone:787-764-2790
Mailing Address - Fax:787-753-7103
Practice Address - Street 1:# 416 PONCE DE LEON AVENUE
Practice Address - Street 2:SUITE. 1511
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3423
Practice Address - Country:US
Practice Address - Phone:787-764-2790
Practice Address - Fax:787-753-7103
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR127103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist