=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164845244
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HILDA ENID VAZQUEZ KARMA PHD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2014
-----------------------------------------------------
Last Update Date | 03/01/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 127 CALLE LILA URB CIUDAD JARDIN
-----------------------------------------------------
City | CAROLINA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00987
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-463-4731
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 127 CALLE LILA CIUDAD JARDIN
-----------------------------------------------------
City | CAROLINA
-----------------------------------------------------
State | PR
-----------------------------------------------------
Zip | 00987
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 787-463-4731
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103T00000X
-----------------------------------------------------
Taxonomy Name | Psychologist
-----------------------------------------------------
License Number | 4351
-----------------------------------------------------
License Number State | PR
-----------------------------------------------------