Healthcare Provider Details

I. General information

NPI: 1356203558
Provider Name (Legal Business Name): CINDY ALEJANDRA VAZQUEZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 W 13 MILE RD
ROYAL OAK MI
48073-6712
US

IV. Provider business mailing address

47161 BAYVIEW CT
CANTON MI
48188-2171
US

V. Phone/Fax

Practice location:
  • Phone: 248-898-5000
  • Fax:
Mailing address:
  • Phone: 313-720-7950
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704295035
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: