| Intermed East Llc | |
|
Font Martelo 123 Street Humacao PR 00791 | |
| (787) 852-3417 | |
| (787) 859-7861 |
| Full Name | Intermed East Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | Font Martelo 123 Street, Humacao, Puerto Rico |
| Authorized Official Name and Position | Idia L Velazquez (M.D.) |
| Authorized Official Contact | 7873428201 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intermed East Llc Po Box 1197 Las Piedras PR 00771-1197 Ph: (787) 342-8201 | Intermed East Llc Font Martelo 123 Street Humacao PR 00791 Ph: (787) 852-3417 |
| NPI Number | 1154741395 |
|---|---|
| Provider Enumeration Date | 04/25/2014 |
| Last Update Date | 04/25/2014 |
| Medicare PECOS PAC ID | 8325264534 |
|---|---|
| Medicare Enrollment ID | O20140724001234 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154741395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 13901 (Puerto Rico) | Primary |
| Provider Name | Idia L Velazquez Lozada |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376570499 PECOS PAC ID: 5496733321 Enrollment ID: I20040708000697 |
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