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General NPI Number Information
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NPI Number | 1184609901
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Entity Type | Individual
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Provider Name | NESTOR L VAZQUEZ MD
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Gender | Male
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Dates
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Enumeration Date | 12/14/2005
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Last Update Date | 01/31/2011
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Provider Practice Location Address
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Address Line | CALLE # 2 KM 39.5 HOSP. WILMA VAZQUEZ SUITE 104
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City | VEGA BAJA
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State | PR
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Zip | 00694-7200
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Country | US
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Telephone | 787-807-1912
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Fax | 787-807-1953
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Provider Business Mailing Address
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Address Line | PO BOX 56096
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City | BAYAMON
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State | PR
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Zip | 00960-6296
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Country | US
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Telephone | 787-807-1912
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Fax | 787-807-1953
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 14126
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License Number State | PR
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