Provider Demographics
NPI:1467294884
Name:VELEZ RODRIGUEZ, JEREMY JOSE SR
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:JOSE
Last Name:VELEZ RODRIGUEZ
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 1 BOX 9444
Mailing Address - Street 2:
Mailing Address - City:TOA BAJA
Mailing Address - State:PR
Mailing Address - Zip Code:00949-9772
Mailing Address - Country:US
Mailing Address - Phone:787-406-9315
Mailing Address - Fax:787-406-9315
Practice Address - Street 1:HC 1 BOX 9444
Practice Address - Street 2:
Practice Address - City:TOA BAJA
Practice Address - State:PR
Practice Address - Zip Code:00949-9772
Practice Address - Country:US
Practice Address - Phone:787-406-9315
Practice Address - Fax:787-406-9315
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician