Healthcare Provider Details

I. General information

NPI: 1568923514
Provider Name (Legal Business Name): PAULA ANDREA VASQUEZ ARRUBLA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2019
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MEDICAL CENTER DR
HARDEEVILLE SC
29927-3446
US

IV. Provider business mailing address

PO BOX 604411
CHARLOTTE NC
28260-4411
US

V. Phone/Fax

Practice location:
  • Phone: 843-689-8149
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS18599
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number93271
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number93611
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: