Provider Demographics
NPI:1982410734
Name:IVAN FRANCISCO VELEZ MONTERO
Entity type:Organization
Organization Name:IVAN FRANCISCO VELEZ MONTERO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IVAN
Authorized Official - Middle Name:FRANCISCO
Authorized Official - Last Name:VELEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:787-378-0676
Mailing Address - Street 1:15 COLINAS DE SAN ANDRES
Mailing Address - Street 2:
Mailing Address - City:UTUADO
Mailing Address - State:PR
Mailing Address - Zip Code:00641-9709
Mailing Address - Country:US
Mailing Address - Phone:787-378-0676
Mailing Address - Fax:
Practice Address - Street 1:CARR. 111 KM 51.7
Practice Address - Street 2:BO. CAGUANA
Practice Address - City:UTUADO
Practice Address - State:PR
Practice Address - Zip Code:00641
Practice Address - Country:US
Practice Address - Phone:939-488-8000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LABOARATORIO CLINICO CAGUANA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-06
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory