Provider Demographics
NPI:1285758748
Name:VELEZ ALICEA, JOSE D (MD)
Entity type:Individual
Prefix:DR
First Name:JOSE
Middle Name:D
Last Name:VELEZ ALICEA
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 225
Mailing Address - Street 2:
Mailing Address - City:ADJUNTAS
Mailing Address - State:PR
Mailing Address - Zip Code:00601-0225
Mailing Address - Country:US
Mailing Address - Phone:787-829-9265
Mailing Address - Fax:
Practice Address - Street 1:J V BOSCH NO 4
Practice Address - Street 2:
Practice Address - City:ADJUNTAS
Practice Address - State:PR
Practice Address - Zip Code:00601-0225
Practice Address - Country:US
Practice Address - Phone:787-829-9265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR7467208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR2-9008Medicare ID - Type Unspecified
PRE-3159Medicare UPIN