Healthcare Provider Details

I. General information

NPI: 1346096740
Provider Name (Legal Business Name): MIRIEL VASQUEZ-CASTRO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N CLAYTON ST
WILMINGTON DE
19805-3165
US

IV. Provider business mailing address

209 CALLOW PL
NEW CASTLE DE
19720-4771
US

V. Phone/Fax

Practice location:
  • Phone: 302-442-3303
  • Fax:
Mailing address:
  • Phone: 302-276-9796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberL1-0042350
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: