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General NPI Number Information
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NPI Number | 1053516252
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Entity Type | Individual
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Provider Name | MRS. JENIFFER M. VAZQUEZ GONZALEZ
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Gender | Female
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 01/29/2010
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Provider Practice Location Address
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Address Line | CALLE TORTOSA 193 ESTANCIAS CHALETS APT 1A1
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City | SAN JUAN
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State | PR
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Zip | 00926-2372
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Country | US
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Telephone | 787-313-0829
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Fax | 787-200-8030
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Provider Business Mailing Address
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Address Line | CALLE TORTOSA 193 ESTANCIAS CHALETS APT 1
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City | SAN JUAN
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State | PR
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Zip | 00926-2372
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Country | US
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Telephone | 787-313-0829
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Fax | 787-200-8030
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1374
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License Number State | PR
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