Provider Demographics
NPI:1427017383
Name:VELEZ MALDONADO, JANET IGDALIA (MD)
Entity type:Individual
Prefix:
First Name:JANET IGDALIA
Middle Name:
Last Name:VELEZ MALDONADO
Suffix:
Gender:F
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:MONTEHIEDRA MALL
Mailing Address - Street 2:159 PITIRRE ST
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-7007
Mailing Address - Country:US
Mailing Address - Phone:787-720-0037
Mailing Address - Fax:
Practice Address - Street 1:1028 AVE ROOSEVELT
Practice Address - Street 2:PUERTO NUEVO
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00920-2904
Practice Address - Country:US
Practice Address - Phone:787-781-8316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR13063207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRH82862Medicare UPIN
PR0020270Medicare ID - Type Unspecified