Healthcare Provider Details

I. General information

NPI: 1083729677
Provider Name (Legal Business Name): ENRIQUE VAZQUEZ ESCARPANTER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 04/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14740 SW 26TH ST STE 107
MIAMI FL
33185-5948
US

IV. Provider business mailing address

14740 SW 26TH ST STE 107
MIAMI FL
33185-5948
US

V. Phone/Fax

Practice location:
  • Phone: 305-388-1118
  • Fax: 305-223-3242
Mailing address:
  • Phone: 305-388-1118
  • Fax: 305-223-3242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberACN260
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: