Healthcare Provider Details

I. General information

NPI: 1003720459
Provider Name (Legal Business Name): JAN J VAZQUEZ RIOS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

997 CALLE SAN ROBERTO
SAN JUAN PR
00926-2759
US

IV. Provider business mailing address

PO BOX 3218
BAYAMON PR
00958-0218
US

V. Phone/Fax

Practice location:
  • Phone: 939-206-6242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPSI48510
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: