Healthcare Provider Details

I. General information

NPI: 1851462378
Provider Name (Legal Business Name): ANA M VAZQUEZ PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 01/03/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CASIA STREET (119)
SAN JUAN PR
00921-3201
US

IV. Provider business mailing address

PO BOX 33028
SAN JUAN PR
00933-3028
US

V. Phone/Fax

Practice location:
  • Phone: 787-641-7582
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number4709
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: