| Doctor Name: | DR. BENJAMIN RICARDO VELAZQUEZ |
| NPI Number: | 1114901162 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 14595 |
| Business Practice Address: | Ave Principal G 19 Urb Baralt Fajardo, PR - 00738 |
| Business Phone Number: | 7878017710 |
| Business Fax Number: | 7878017710 |
| Mailing Address: | Calle 7 #132, Santa Isidra Ii FAJARDO |
| State: | PR |
| Postal Code: | 00738 |
| Phone Number: | 7878017710 |
| Fax Number: | 7878017710 |
| NPI Enumeration Date: | 12/02/2005 |
| NPI Last Update Date: | 04/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 14595 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PR |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |