Provider Demographics
NPI:1174729198
Name:DE LA CRUZ VELEZ, ROLANDO
Entity type:Individual
Prefix:MR
First Name:ROLANDO
Middle Name:
Last Name:DE LA CRUZ VELEZ
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CARR. 446 KM. 6.0
Mailing Address - Street 2:BUZON 4220 BO. LLANADAS
Mailing Address - City:ISABELA
Mailing Address - State:PR
Mailing Address - Zip Code:00662
Mailing Address - Country:US
Mailing Address - Phone:787-934-5624
Mailing Address - Fax:
Practice Address - Street 1:410 AVE HOSTOS SUITE 7
Practice Address - Street 2:CENTRO SALUD MENTAL MAYAGUEZ
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00682-1522
Practice Address - Country:US
Practice Address - Phone:787-934-5624
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator