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General NPI Number Information
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NPI Number | 1760301287
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Entity Type | Individual
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Provider Name | KEVIN RYAN VAZQUEZ OD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2026
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Last Update Date | 07/10/2026
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Provider Practice Location Address
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Address Line | 2517 NE 10TH CT
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City | HOMESTEAD
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State | FL
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Zip | 33033-4719
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Country | US
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Telephone | 305-242-0996
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Fax |
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Provider Business Mailing Address
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Address Line | 12715 SW 112TH TER
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City | MIAMI
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State | FL
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Zip | 33186-4720
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Country | US
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Telephone | 786-763-5958
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7029
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License Number State | FL
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