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General NPI Number Information
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NPI Number | 1790038453
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Entity Type | Individual
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Provider Name | NOEMI VAZQUEZ M.T.
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Gender | Female
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | URB CAMINO DEL SOL 305 CAMINO DE LA COLINA
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City | VEGA BAJA
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State | PR
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Zip | 00693
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Country | US
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Telephone | 787-473-6754
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8594
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City | BAYAMON
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State | PR
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Zip | 00960-8594
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Country | US
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Telephone | 787-473-6753
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 7010
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License Number State | PR
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