Provider Demographics
NPI:1962926469
Name:VELAZQUEZ GARCIA, ANDRES IVAN (MD)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:IVAN
Last Name:VELAZQUEZ GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:CALLE GARDENIAH38
Mailing Address - Street 2:CONDADO VIEJO
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00725
Mailing Address - Country:US
Mailing Address - Phone:787-466-6665
Mailing Address - Fax:
Practice Address - Street 1:CALLE GARDENIAH38
Practice Address - Street 2:CONDADO VIEJO
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-466-6665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-27
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR22564207P00000X, 207P00000X
PR34296-R390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine