Healthcare Provider Details

I. General information

NPI: 1184812893
Provider Name (Legal Business Name): YAMILA VAZQUEZ GONZALEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: YAMILA VAZQUEZ GONZALEZ MD

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8750 SW 144TH ST
PALMETTO BAY FL
33176-7296
US

IV. Provider business mailing address

PO BOX 161387
ALTAMONTE SPRINGS FL
32716-1387
US

V. Phone/Fax

Practice location:
  • Phone: 877-346-2211
  • Fax:
Mailing address:
  • Phone: 877-346-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME119573
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: