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General NPI Number Information
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NPI Number | 1245799741
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Entity Type | Individual
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Provider Name | IVONNE MARITZA VASQUEZ DDS
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Gender | Female
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Dates
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Enumeration Date | 03/14/2019
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 7244 W MCNAB RD
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City | NORTH LAUDERDALE
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State | FL
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Zip | 33068-5441
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Country | US
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Telephone | 954-341-0002
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Fax |
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Provider Business Mailing Address
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Address Line | 3350 WATER OAK DR
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City | HOLLYWOOD
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State | FL
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Zip | 33021-8430
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Country | US
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Telephone | 954-993-5615
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN26218
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License Number State | FL
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