Healthcare Provider Details

I. General information

NPI: 1235277153
Provider Name (Legal Business Name): ADELA ISABEL VAZQUEZ BSPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

URB BRISAS DEL MAR
LUQUILLO PR
00773
US

IV. Provider business mailing address

PO BOX 145
PALMER PR
00721-0145
US

V. Phone/Fax

Practice location:
  • Phone: 787-889-4880
  • Fax: 787-889-0410
Mailing address:
  • Phone: 787-887-2805
  • Fax: 787-887-2805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number1025
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: