Healthcare Provider Details

I. General information

NPI: 1760007082
Provider Name (Legal Business Name): JOSEFINA VAZQUEZ GARCIA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2020
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N MILITARY TRL STE 105
BOCA RATON FL
33431-6347
US

IV. Provider business mailing address

1877 MEADOW CT
WEST PALM BEACH FL
33406-6747
US

V. Phone/Fax

Practice location:
  • Phone: 561-249-6114
  • Fax:
Mailing address:
  • Phone: 786-878-4614
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDN24952
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: