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General NPI Number Information
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NPI Number | 1508951195
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Entity Type | Individual
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Provider Name | LUIS J VAZQUEZ URQUIA OPTOMETRIST
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | LOS ARCOS DE SUCHVILLE # 105 CALLE 3 #81
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City | GUAYNABO
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State | PR
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Zip | 00966-1679
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Country | US
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Telephone | 787-773-7987
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Fax | 787-754-6695
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Provider Business Mailing Address
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Address Line | LOS ARCOS DE SUCHVILLE # 105 CALLE 3 #81
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City | GUAYNABO
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State | PR
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Zip | 00966-1679
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Country | US
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Telephone | 787-773-7987
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Fax | 787-754-6695
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 000536
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License Number State | PR
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