Provider Demographics
NPI:1811695711
Name:VELEZ RONDA, CARLA ISABEL
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:ISABEL
Last Name:VELEZ RONDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 CALLE LOS ROBLES URB EL VALLE
Mailing Address - Street 2:
Mailing Address - City:LAJAS
Mailing Address - State:PR
Mailing Address - Zip Code:00667-1655
Mailing Address - Country:US
Mailing Address - Phone:939-238-7525
Mailing Address - Fax:
Practice Address - Street 1:992 AVE HOSTOS
Practice Address - Street 2:
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1250
Practice Address - Country:US
Practice Address - Phone:787-831-9251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-20
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR8326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist