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General NPI Number Information
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NPI Number | 1316193147
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Entity Type | Individual
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Provider Name | BRIDGET JARINELLE VAZQUEZ MT
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Gender | Female
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Dates
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Enumeration Date | 08/12/2008
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Last Update Date | 08/12/2008
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Provider Practice Location Address
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Address Line | CALLE 1 # 829 BO PINAS
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City | TOA ALTA
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State | PR
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Zip | 00953-1837
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Country | US
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Telephone | 787-730-7777
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Fax |
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Provider Business Mailing Address
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Address Line | RR 14 BOX 5334 BO DAJAOS
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City | BAYAMON
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State | PR
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Zip | 00956-9711
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Country | US
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Telephone | 787-730-7777
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 6789
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License Number State | PR
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