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General NPI Number Information
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NPI Number | 1679629422
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Entity Type | Individual
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Provider Name | REINALDO M VAZQUEZ OD
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Gender | Male
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 53 CALLE CORAL REPTO PUEBLO NUEVO
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City | SAN GERMAN
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State | PR
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Zip | 00683-4306
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Country | US
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Telephone | 787-264-4431
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Fax | 787-833-9200
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Provider Business Mailing Address
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Address Line | 53 CALLE CORAL REPTO PUEBLO NUEVO
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City | SAN GERMAN
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State | PR
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Zip | 00683-4306
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Country | US
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Telephone | 787-264-4431
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Fax | 787-833-9200
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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 | 559
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License Number State | PR
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