Healthcare Provider Details

I. General information

NPI: 1225229610
Provider Name (Legal Business Name): LAURA DE LA CARIDAD VAZQUEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2007
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 SW 97TH AVE STE 201
MIAMI FL
33173-1407
US

IV. Provider business mailing address

7001 SW 97TH AVE STE 201
MIAMI FL
33173-1407
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-4478
  • Fax: 305-595-5027
Mailing address:
  • Phone: 305-595-4478
  • Fax: 305-595-5027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME99366
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: