Provider Demographics
NPI:1215162656
Name:VELAZQUEZ-CORREA, ROBERTO KARLO (MD)
Entity type:Individual
Prefix:
First Name:ROBERTO
Middle Name:KARLO
Last Name:VELAZQUEZ-CORREA
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:PO BOX 1185
Mailing Address - Street 2:
Mailing Address - City:AGUAS BUENAS
Mailing Address - State:PR
Mailing Address - Zip Code:00703-1185
Mailing Address - Country:US
Mailing Address - Phone:787-642-1440
Mailing Address - Fax:
Practice Address - Street 1:STREET 790 KM-1, HM-0
Practice Address - Street 2:BO. BAYAMONCITO
Practice Address - City:AGUAS BUENAS
Practice Address - State:PR
Practice Address - Zip Code:00703
Practice Address - Country:US
Practice Address - Phone:787-642-1440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR17573207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine