Provider Demographics
NPI:1194719542
Name:VELEZ MONTIJO, LIONEL (MD)
Entity type:Individual
Prefix:
First Name:LIONEL
Middle Name:
Last Name:VELEZ MONTIJO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CALLE VIA MARBELLA #471
Mailing Address - Street 2:URB PASEO DEL MAR
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646
Mailing Address - Country:US
Mailing Address - Phone:787-796-7807
Mailing Address - Fax:787-778-1567
Practice Address - Street 1:73 CALLE SANTA CRUZ
Practice Address - Street 2:STE 409 SANTA CRUZ MEDICAL BUILDING
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-778-1567
Practice Address - Fax:787-778-1567
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PR12152207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRVE88557Medicare ID - Type Unspecified
H55196Medicare UPIN