Provider Demographics
NPI:1316915457
Name:CARO VELAZQUEZ, MARITZA (PH D)
Entity type:Individual
Prefix:DR
First Name:MARITZA
Middle Name:
Last Name:CARO VELAZQUEZ
Suffix:
Gender:F
Credentials:PH D
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 11850
Mailing Address - Street 2:SUITE 251
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00922-1850
Mailing Address - Country:US
Mailing Address - Phone:787-347-5869
Mailing Address - Fax:
Practice Address - Street 1:2D33 CALLE PINO
Practice Address - Street 2:URB. VILLA DEL REY
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-6254
Practice Address - Country:US
Practice Address - Phone:787-347-5869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1510103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical