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General NPI Number Information
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NPI Number | 1396672689
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Entity Type | Individual
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Provider Name | AZAIRA COLON VAZQUEZ
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Gender | Female
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Dates
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Enumeration Date | 05/08/2026
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Last Update Date | 05/08/2026
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Provider Practice Location Address
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Address Line | 2118 PONCE BY PASS LOCAL A SUITE A URB. INDUSTRIAL REPARADA
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City | PONCE
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State | PR
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Zip | 00716-0315
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Country | US
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Telephone | 787-223-2029
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Fax |
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Provider Business Mailing Address
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Address Line | URB. HEDA LA MATILDE 5461 CALLE SURCO
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City | PONCE
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State | PR
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Zip | 00728-2443
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Country | US
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Telephone | 787-247-9758
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 001417
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License Number State | PR
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