Healthcare Provider Details

I. General information

NPI: 1902259294
Provider Name (Legal Business Name): LIONEL DAVID VAZQUEZ-FIGUEROA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AV AMERICO MIRANDA S/N CENTRO MEDICO
SAN JUAN PR
00935-2842
US

IV. Provider business mailing address

1500 AVE LOS ROMEROS APT 404
SAN JUAN PR
00926-7013
US

V. Phone/Fax

Practice location:
  • Phone: 787-474-0333
  • Fax: 787-753-6390
Mailing address:
  • Phone: 787-923-6175
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number15282
License Number StatePR
# 2
Primary TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number036.172386
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number35557
License Number StatePR
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036.172386
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: