Healthcare Provider Details

I. General information

NPI: 1699111898
Provider Name (Legal Business Name): ROCIO VAZQUEZ DO CAMPO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2013
Last Update Date: 06/29/2023
Certification Date:
Deactivation Date: 03/31/2014
Reactivation Date: 06/03/2014

III. Provider practice location address

2000 6TH AVE S
BIRMINGHAM AL
35233-2110
US

IV. Provider business mailing address

2000 6TH AVE S
BIRMINGHAM AL
35233-2110
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-9999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number38538
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: