Basic Information
| Provider Information | |||||||||
| NPI: | 1306467857 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VAZQUEZ, MD P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8600 SW 92ND ST STE 204A | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331567377 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3052167312 | ||||||||
| FaxNumber: | 3055002137 | ||||||||
| Practice Location | |||||||||
| Address1: | 10794 PINES BLVD STE 205 | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330263920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9545388543 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2020 | ||||||||
| LastUpdateDate: | 05/06/2020 | ||||||||
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| AuthorizedOfficialLastName: | VAZQUEZ | ||||||||
| AuthorizedOfficialFirstName: | ZAEL | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7865104212 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 05/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease |
No ID Information.