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General NPI Number Information
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NPI Number | 1851064307
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Entity Type | Individual
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Provider Name | PEDRO-JUAN VAZQUEZ BRAGAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/30/2021
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Last Update Date | 07/30/2021
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Provider Practice Location Address
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Address Line | HOSPITAL SAN CRISTOBAL, CALLE ACEROLA, COTO LAUREL
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City | PONCE
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State | PR
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Zip | 00780
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Country | US
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Telephone | 787-842-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 186 PR 2 ACQUALINA 801
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City | GUAYNABO
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State | PR
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Zip | 00966
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Country | US
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Telephone | 787-342-3026
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 22447
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 15625I
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License Number State | PR
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