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General NPI Number Information
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NPI Number | 1649992785
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Entity Type | Individual
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Provider Name | DR. YULIA NIETO VAZQUEZ
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Gender | Female
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Dates
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Enumeration Date | 09/15/2022
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 2614 NE 10TH CT
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City | HOMESTEAD
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State | FL
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Zip | 33033-4712
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Country | US
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Telephone | 305-242-0377
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Fax |
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Provider Business Mailing Address
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Address Line | 16544 SW 85TH LN
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City | MIAMI
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State | FL
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Zip | 33193-5794
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Country | US
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Telephone | 786-728-5682
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS62987
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License Number State | FL
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