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General NPI Number Information
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NPI Number | 1134074800
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Entity Type | Individual
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Provider Name | JERAMIND SCOTT VAZQUEZ
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Gender | Male
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | PO BOX 4055
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City | AGUADILLA
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State | PR
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Zip | 00605-4055
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Country | US
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Telephone | 787-658-0012
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Fax |
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Provider Business Mailing Address
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Address Line | URB. COSTA BRAVA, CALLE ZIRCONIA #210
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City | ISABELA
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State | PR
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Zip | 00662
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Country | US
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Telephone | 787-235-6953
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Fax |
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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 | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number |
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License Number State | PR
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