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General NPI Number Information
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NPI Number | 1639587843
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Entity Type | Individual
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Provider Name | JOSE JAVIER DIAZ VAZQUEZ MSPT
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Gender | Male
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Dates
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Enumeration Date | 07/31/2014
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Last Update Date | 08/06/2023
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Provider Practice Location Address
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Address Line | HC 4 BOX 9340
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City | UTUADO
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State | PR
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Zip | 00641-7722
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Country | US
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Telephone | 939-274-0837
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Fax |
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Provider Business Mailing Address
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Address Line | HC 4 BOX 9340
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City | UTUADO
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State | PR
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Zip | 00641-7722
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Country | US
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Telephone | 939-274-0837
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 4519
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License Number State | PR
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