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General NPI Number Information
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NPI Number | 1609080803
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Entity Type | Individual
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Provider Name | ENGRACIA TRUYOL-VAZQUEZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 383 AVE FD ROOSEVELT
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City | SAN JUAN
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State | PR
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Zip | 00918-2143
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Country | US
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Telephone | 787-622-5687
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Fax | 888-899-0977
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Provider Business Mailing Address
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Address Line | 383 AVE FD ROOSEVELT
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City | SAN JUAN
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State | PR
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Zip | 00918-2143
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Country | US
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Telephone | 787-622-5687
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Fax | 888-899-0977
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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 | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 2634
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 2643
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License Number State | PR
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