Healthcare Provider Details

I. General information

NPI: 1336112572
Provider Name (Legal Business Name): MARIA JULIA VAZQUEZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 AVE FONT MARTELO
HUMACAO PR
00791-3249
US

IV. Provider business mailing address

URB. VILLA UNIVERSITARIA BG 3 CALLE 13
HUMACAO PR
00791-4329
US

V. Phone/Fax

Practice location:
  • Phone: 787-852-0768
  • Fax:
Mailing address:
  • Phone: 787-362-5994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number14617
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: