Provider Demographics
NPI:1588304448
Name:ZAYAS VELEZ, JULIAN JOSE
Entity type:Individual
Prefix:
First Name:JULIAN
Middle Name:JOSE
Last Name:ZAYAS VELEZ
Suffix:
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:PO BOX 361108
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-1108
Mailing Address - Country:US
Mailing Address - Phone:787-232-3972
Mailing Address - Fax:
Practice Address - Street 1:ESTANCIAS DEL BOSQUE, 708, CALLE 1
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-0708
Practice Address - Country:US
Practice Address - Phone:787-232-3972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR6631771390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program