Healthcare Provider Details

I. General information

NPI: 1710680699
Provider Name (Legal Business Name): VAZCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19105 N US HIGHWAY 41 STE 300
LUTZ FL
33549-4206
US

IV. Provider business mailing address

20212 NATURES SPIRIT DR # 2712
TAMPA FL
33647-3582
US

V. Phone/Fax

Practice location:
  • Phone: 787-421-8330
  • Fax: 833-330-3042
Mailing address:
  • Phone: 787-421-8330
  • Fax: 833-330-3042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. YARED VAZQUEZ
Title or Position: PHYSICIAN
Credential: MD
Phone: 787-421-8330