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General NPI Number Information
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NPI Number | 1649951674
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Entity Type | Organization
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Legal Business Name | HERITAGE MEDICAL CARE INC
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 09/20/2025
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Provider Practice Location Address
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Address Line | 8200 W SUNRISE BLVD STE A-5
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City | PLANTATION
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State | FL
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Zip | 33322-5426
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Country | US
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Telephone | 954-314-7423
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Fax | 954-314-7426
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Provider Business Mailing Address
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Address Line | 8200 W SUNRISE BLVD
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City | PLANTATION
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State | FL
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Zip | 33322-5426
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Country | US
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Telephone | 954-314-7423
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Fax | 954-314-7426
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Authorized Official
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Title or Position | PRESIDENT
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Name | GLORIA M VAZQUEZ
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Credential | MD
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Telephone | 954-314-7423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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