Provider Demographics
NPI:1992724504
Name:VELEZ, EDNA L
Entity type:Individual
Prefix:MRS
First Name:EDNA
Middle Name:L
Last Name:VELEZ
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 1:2 F20
Mailing Address - Street 2:URB PARQUE DE MONTEBELLO
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-761-1337
Mailing Address - Fax:
Practice Address - Street 1:F20 CALLE 2
Practice Address - Street 2:URB PARQUE DE MONTEBELLO
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976-3827
Practice Address - Country:US
Practice Address - Phone:787-761-1337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR0226225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist