MEDICARE: MR. ALMANZAR PEREZ VASQUEZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	7136	PR

General Provider Information

NPI Number	:	1396835377
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALMANZAR PEREZ VASQUEZ MD

Provider Business Mailing Address
First Line	:	PO BOX 4444
Second Line	:
City	:	AGUADILLA
State	:	PR
Zip	:	00605
Country	:	US
Telephone Number	:	787-890-0475
Fax Number	:

Provider Business Practice Location Address
First Line	:	AV RAMEY
Second Line	:	#20
City	:	SAN ANTONIO
State	:	PR
Zip	:	00690
Country	:	US
Telephone Number	:	787-890-0475
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	07/08/2007

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