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General NPI Number Information
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NPI Number | 1003019928
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Entity Type | Organization
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Legal Business Name | CENTRO INTERAMERICANO DE GINECOLOGIA Y OBSTETRICIA
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | CARR.734 SALIDA PARA CAYEY
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City | CIDRA
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State | PR
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Zip | 00739
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Country | US
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Telephone | 787-739-0606
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Fax | 787-739-0606
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Provider Business Mailing Address
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Address Line | PMB-25 BOX 4952
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City | CAGUAS
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State | PR
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Zip | 00726-4952
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Country | US
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Telephone | 787-739-0606
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Fax | 787-739-0606
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Authorized Official
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Title or Position | PARTNER
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Name | DR. GONZALO VAZQUEZ
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Credential | M.D.
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Telephone | 787-739-0606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 10457
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License Number State | PR
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