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General NPI Number Information
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NPI Number | 1184667198
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Entity Type | Individual
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Provider Name | JOSE EMILIO VASQUEZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 10/08/2012
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Provider Practice Location Address
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Address Line | 214 MORRISON RD SUITE 104
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City | BRANDON
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State | FL
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Zip | 33511-4849
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Country | US
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Telephone | 813-681-6474
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Fax | 813-654-8473
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Provider Business Mailing Address
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Address Line | 214 MORRISON RD SUITE 104
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City | BRANDON
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State | FL
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Zip | 33511-4849
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Country | US
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Telephone | 813-681-6474
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Fax | 813-654-8473
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | ME77683
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License Number State | FL
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