Physician Compare National (NPI:1790199271)

HEALTHCARE PROVIDER: ILEANA VAZQUEZ OTERO MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1790199271
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668701079
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190910003991
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VAZQUEZ OTERO
	Individual professional last name
Provider First Name	ILEANA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF PUERTO RICO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2014
	Individual professional's medical school graduation year
Primary Specialty	RHEUMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	270 CALLE SAN JORGE
	Group Practice or individual's line 1 address
City	SANTURCE
	Group Practice or individual's city
State	PR
	Group Practice or individual's state
Zip Code	009123352
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7877271000
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y